Centerpiece钛板内固定在单开门颈椎管扩大成形术中的应用

Application of Centerpiece titanium plate internal fixation in expansive open-door laminoplasty of cervical spine

目的分析在单开门颈椎管扩大成形术中应用Centerpiece钛板内固定的临床效果。方法40例颈椎管狭窄症行颈椎后路单开门颈椎管扩大成形术患者,随机分为A组及B组,各20例。A组采用Centerpiece微型钛板内固定法对开门侧进行维持固定,B组采用锚定法对开门侧进行维持固定。对比两组术前及术后的日本骨科协会(JOA)评分、视觉模拟评分法(VAS)评分、颈椎功能障碍指数(NDI)、C3~7夹角、颈椎活动度(ROM)、椎管矢状径、椎管横截面积及椎管扩大率、并发症发生情况。结果术前,两组JOA评分、VAS评分、NDI指数对比,差异均无统计学意义(P>0.05);术后,A组JOA评分为(15.34±1.23)分、VAS评分为(1.23±0.56)分、NDI指数为(6.45±1.78)%,B组JOA评分为(10.63±1.52)分、VAS评分为(2.93±0.35)分、NDI指数为(15.82±3.63)%。术后,A组JOA评分高于B组,VAS评分及NDI指数低于B组,差异均具有统计学意义(P<0.05)。术前,两组C3~7夹角、颈椎ROM、椎管矢状径、椎管横截面积对比,差异均无统计学意义(P>0.05);术后,A组C3~7夹角、颈椎ROM小于B组,椎管矢状径、椎管横截面积大于B组,差异均具有统计学意义(P<0.05)。A组椎管扩大率为(58.36±3.46)%,大于B组的(43.15±2.99)%,差异具有统计学意义(P<0.05)。A组并发症发生率为10.00%,低于B组的40.00%,差异具有统计学意义(P<0.05)。结论在单开门颈椎管扩大成形术中应用Centerpiece钛板内固定的临床效果确切,可使椎体功能得到改善,减少并发症的发生,具有显著临床价值。

Objective To analyze the clinical effect of Centerpiece titanium plate internal fixation in expansive open-door laminoplasty of cervical spine.Methods A total of 40 cervical spinal stenosis patients with expansive open-door laminoplasty of cervical spine were randomly divided into group A and group B,with 20 cases in each group.Group A received Centerpiece mini-titanium plate internal fixation to maintain and fix the door opening side,group B received anchoring to maintain and fix the door opening side.The Japanese Orthopaedic Association(JOA)score,visual analogue scale(VAS)score,neck disability index(NDI),C3~7 angle,range of motion(ROM),sagittal diameter,cross-sectional area of spinal canal,spinal canal enlargement rate before and after surgery,and occurrence of complication were compare between the two groups.Results Before surgery,there was no statistically significant difference in JOA score,VAS score,and NDI between the two groups(P>0.05).After surgery,JOA score,VAS score,and NDI of group A were(15.34±1.23)points,(1.23±0.56)points and(6.45±1.78)%,which were(10.63±1.52)points,(2.93±0.35)points and(15.82±3.63)%of group B.After surgery,JOA score of group A was higher than that of group B,and VAS score and NDI were lower than those of group B,and the difference was statistically significant(P<0.05).Before surgery,there was no statistically significant difference in C3-7 angle,cervical ROM,sagittal diameter and cross-sectional area of spinal canal between the two groups(P>0.05).After surgery,C3-7 angle,cervical ROM of group A were lower than those of group B,and sagittal diameter and cross-sectional area of spinal canal of were larger than those of group B,and the difference was statistically significant(P<0.05).The spinal canal enlargement rate of group A was(58.36±3.46)%,which was higher than that of group B(43.15±2.99)%,and the difference was statistically significant(P<0.05).The incidence of complications of group A was 10.00%,which was lower than that of group B 40.00%,and the difference was statistically significant(P<0.05).Conclusion Centerpiece titanium plate internal fixation shows affirmative clinical effect in expansive open-door laminoplasty of cervical spine,which can improve the function of vertebral body and reduce the occurrence of complications.This method contains remarkable clinical value.