颈椎经后路单开门椎管成形术配合双侧侧块钉棒内固定术治疗脊髓型颈椎病

Posterior Single Open Door Laminoplasty Combined with Bilateral Mass Screw Rod Internal Fixation in Treatment of Cervical Spondylotic Myelopathy

目的探讨治疗脊髓型颈椎病经后路单开门椎管成形术配合双侧侧块钉棒内固定术的临床疗效。方法对55例脊髓型颈椎病患者行经后路单开门椎管成形术+双侧侧块钉棒系统内固定术,记录手术时间、手术出血量、术后引流量、手术前后神经功能JOA分值,记录术前术后神经功能恢复情况、颈椎活动度及术后轴性症状发生率。结果 55例均得到回访,术后较术前神经功能恢复率为(57.557±9.145)%,术后较术前颈椎活动度减少(5.78±4.35)°,数据差异有统计学意义(P<0.01),术后有轴性症状患者的比例为58.1%。结论为颈椎后路单开门椎管成形+双侧钉棒系统内固定术治疗脊髓型颈椎病疗效确切,神经功能明显恢复,并保持了的颈椎稳定性,减少了术后轴性症状的发生,对脊髓型颈椎病疗效好。

Objective To investigate the clinical effect of posterior single open door laminoplasty combined with bilateral mass screw rod internal fixation in the treatment of cervical Spondylotic myelopathy. Methods 55 cases of patients with cervical Spondylotic myelopathy were treated with posterior single open door laminoplasty combined with bilateral mass screw rod internal fixation.The time of operation,the amount of blood loss,the postoperative drainage,the JOA score of nerve function before and after operation,the recovery of nerve function before and after operation,the degree of cervical spine movement and the incidence of postoperative axial symptoms were all recorded.Results All the 55 patients were visited back.Compared with preoperative,the recovery rate of nerve function after operation was（ 57. 557±9. 145） %,and the postoperative cervical movement decreased by（ 5. 78± 4. 35） °,statistically significant（ P〈0. 01）.And the proportion of patients with axial symptoms after operation was 58. 1%.Conclusion The posterior single open door laminoplasty combined with bilateral mass screw rod internal fixation is effective in the treatment of cervical Spondylotic myelopathy with obviously recovered nerve function,maintained stability of cervical spine,reduced incidence of postoperative axial symptoms,and good effect on cervical Spondylotic myelopathy.