微型钛板应用于颈椎病后路单开门椎管扩大成形术的疗效观察

Clinical efficacy of titanium micro-plate on the unilateral open-door cervical expansive laminoplasty for cervical spondylopathy

目的：比较颈椎单开门椎管扩大成形术中微型钛板固定与缝线悬吊固定方式对临床疗效的影响，评价微型钛板的临床应用价值。方法选择2009年1月至2016年1月开展的颈椎后路单开门椎管扩大成形术41例进行观察，其中 A 组21例，行缝线悬吊固定；B 组20例，行微型钛板固定。比较两组随访时 JO 评分改善率、颈椎曲度变化、椎板掀开角度及轴性症状。结果两组随访6-70个月，平均34个月。两组 JOA 评分改善率比较差异未见统计学意义（P ﹥0.05）；术后维持颈椎曲度比较差异有统计学意义（P ﹤0.05），且 B 组较 A 组能更好地维持颈椎正常曲度；两组维持椎板开门角度比较差异有统计学意义（P ﹤0.05），且 B 组维持椎板开门更稳定；两组轴性症状比较差异有统计学意义（P ﹤0.05），B 组轴性症状轻于 A 组。结论颈椎单开门椎管扩大成形术中微型钛板固定与缝线悬吊固定治疗颈椎病均能获得较好的临床疗效，但微型钛板固定在维持颈椎正常曲度、减压效果及减轻术后轴性症状方面效果更满意。

Objective To compare the clinical efficacy of titanium micro-plate and suture sus-pension on the unilateral open-door cervical expansive laminoplasty for cervical spondylopathy. Methods From January 2009 to January 2016,41 patients underwent unilateral open-door cervical ex-pansive laminoplasty were selected. All patients were divided into two groups：group A,21 cases of＆amp;nbsp;laminoplasty by using suture suspension,group B,20 cases of laminoplasty by using titanium micro-plate. The improvement rate of JOA score,value of cervical curvature,angle of open-door and axial symptoms and the efficacy of the two groups were compared. Results The two groups were followed up for 6 to 70 months,with an average of 34 months. There was no significant difference between the two groups in the improvement rate of JOA score（P ﹥ 0. 05）,but the maintainence of cervical curvature and opened-lamina angle,and axial symptoms were significanty different between the two groups（P ﹤ 0. 05）, and group B had a better outcome than that of Group A. Conclusions Unilateral open-door cervical ex-pansive laminoplasty with both titanium micro-plate fixation and suture suspension technique has good clinical efficacy on cervical spondylopathy,but the titanium micro-plate fixation can make better outcome in the maintainence of postoperative cervical curvature and cervical cannal decompression and the reduce-ment of axial symptoms.