单开门颈椎管扩大成形术治疗多节段脊髓型颈椎病的疗效观察

The clinical efficacy of single-door cervical expansive laminoplasty for multi-segment cervical spondylotic myelopathy

目的探讨单开门颈椎管扩大成形术治疗多节段脊髓型颈椎病的临床疗效。方法回顾性分析自2014-10—2017-07采用单开门颈椎管扩大成形术治疗的38例多节段脊髓型颈椎病,比较术前与末次随访时椎管矢状径、椎管横截面积、NDI指数、JOA评分、疼痛VAS评分。结果38例均顺利完成手术并获得至少24个月的随访。9例出现轴性症状,1例出现C5神经根麻痹,1例出现颈部肿胀、四肢肌力进行性下降,对症处理后均治愈。末次随访时椎管矢状径、NDI指数、疼痛VAS评分较术前降低,椎管横截面积、JOA评分较术前增大,差异有统计学意义(P<0.05)。结论单开门颈椎管扩大成形术治疗多节段脊髓型颈椎病能够获得较好的中期临床效果和脊髓功能。

Objective To investigate the clinical effect of single-door cervical expansive laminoplasty for multi-segment cervical spondylotic myelopathy.Methods A retrospective analysis was performed on 38 multi-segment cervical spondylotic myelopathy patients who received single-door cervical expansive laminoplasty in our hospital from October 2014 to July 2017.The sagittal diameter,cross-sectional area,NDI index,JOA score and pain VAS score of spinal canal before operation and at the final follow-up were compared.Results All 38 cases completed the operation successfully and were followed up for at least 24 months.Axial symptoms occurred in 9 cases,C5 nerve root paralysis in 1 case,neck swelling and progressive decline of limb muscle strength in 1 case.All cases were cured after symptomatic treatment.At the final follow-up,the sagittal diameter,NDI index and pain VAS score of spinal canal were lower than those before operation,and the cross-sectional area and JOA score of spinal canal were higher than those before operation,the difference was statistically significant(P<0.05).Conclusion Singledoor cervical expansive laminoplasty for the treatment of multiple-segmental cervical spondylotic myelopathy can achieve good mid-term clinical effect and spinal cord function.