C3~6单开门椎板成形术治疗多节段脊髓型颈椎病

C3-6 Single Open-door Laminoplasty in the Treatment of Multilevel Cervical Spondylotic Myelopathy

目的:评估C3~6单开门椎板成形术治疗多节段脊髓型颈椎病的效果。方法:回顾性分析2014年1月-2017年7月行后路C3~6单开门颈椎板成形术的17例多节段脊髓型颈椎病患者的临床资料。比较手术前后日本骨科协会(JOA)评分、颈椎前凸角度、颈椎曲度指数、脊髓向后漂移距离。观察术后颈椎轴性症状及不良事件发生情况。结果:术后随访12~50个月,平均随访18个月。术后12个月JOA评分、颈椎前凸角度、颈椎曲度指数、脊髓向后漂移距离与术前比较,差异均有统计学意义(P<0.01)。术后无颈椎轴性症状发生。术后无C5神经根麻痹,无脑脊液漏及内置物断裂等不良事件发生。结论:C3~6单开门椎板成形术能够使颈脊髓向后漂移,改善神经功能,降低术后轴性症状发生。

Objective:To evaluate the effect of C3-6 single open-door laminoplasty in the treatment of multilevel cervical spondylotic myelopathy.Method:The clinical data of 17 patients with multilevel cervical spondylotic myelopathy who underwent C3~6 single open-door laminoplasty from January 2014 to July 2017 were retrospectively analyzed.The Japanese orthopaedic association (JOA) score,cervical lordosis angle,cervical curvature index,and spinal cord backward drift distance before and after surgery were compared.Postoperative cervical axial symptoms and adverse events were observed.Result:Postoperative follow-up ranged from 12 to 50 months,with an average follow-up of 18 months.The JOA score,cervical lordosis angle,cervical curvature index,and spinal cord backward drift distance at 12 months after surgery showed statistically significant differences compared with those before surgery (P<0.01).There was no cervical axial symptom after surgery.There were no C5 nerve root paralysis,no cerebrospinal fluid leakage,no internal material fracture and other adverse events after surgery.Conclusion:C3-6 single open-door laminoplasty can cause the cervical spinal cord backward drift,improve nerve function,and reduce the occurrence of postoperative cervical axial symptom.