颈围领使用时间对颈椎管成形术后疗效的影响

Impact on the cervical axial symptom due to different duration of cervical collar in situ following laminoplasty

目的:探讨颈围领使用时间的长短对颈椎管成形术后疗效的影响。方法:回顾性分析因脊髓型颈椎病在我科行颈椎管成形术(单开门术式)后使用颈围领时间不同的患者40例,其中术后颈围领使用时间6周20例(A组),术后颈围领使用时间12周20例(B组),分别随访记录患者术前、术后JOA评分、Cobb角丢失、轴性症状发生率以及术后门轴侧融合率等指标,比较两组患者近远期的疗效,对两组颈围领使用时间不同疗效进行评价。结果:两组患者术前JOA评分差异无统计学意义(P>0.05);A组近期与远期JOA评分、Cobb角丢失与B组比较差异均无统计学意义(P>0.05),术后颈椎曲度得到良好的维持;同时术后A组出现轴性症状患者(5例)比例明显小于B组(12例)(P<0.05)。结论:适当缩短颈围的使用时间可减少患者术后轴性症状的发生率。

Objective： To investigate the impact of different duration of cervical collar in situ on cervical axial symptom in patients following laminoplasty.Methods： Retrospective analysis was performed in 40 patients with cervical collar in situ in different duration following laminoplasty（ single open-door approach） because of cervical spondylotic myelopathy.The patients were allocated to group A（ n = 20,6 weeks） and group B（ n = 20,12 weeks） by the duration of wearing a cervical collar following surgery.Two groups were maintained pertaining to the JOA scores and loss of Cobb angle before and after operation,postoperative incidence of axial symptom index of lateral fusion,and compared regarding the short-and long-term effect by different duration of cervical collar in situ.Results： The two groups were not significantly different concerning preoperative scoring on JOA as well as short-and long-term effect by JOA scores and loss of Cobb angle（ P〈0.05）.Although cervical curvature was well maintained in two groups following operation,yet group A had fewer incidence of cervical axial symptom than group B（ 5 cases vs.12 cases）（ P〈0.05）.Conclusion： Early withdrawal of the cervical collar can reduce the incidence of axial symptoms.