颈椎后路单开门椎管扩大椎板成形术治疗脊髓型颈椎病合并颈源性头痛的临床疗效

Clinical efficacy of posterior single-door laminoplasty for treatment of cervical spondylotic myelopathywith cervicogenic headache

目的探讨颈椎后路单开门椎管扩大椎板成形术治疗多节段脊髓型颈椎病(MCSM)合并颈源性头痛的临床疗效。方法2018年1月—2021年6月,采用颈椎后路单开门椎管扩大椎板成形术治疗MCSM合并颈源性头痛患者31例,术前及术后1、3、12个月采用日本骨科学会(JOA)评分评价临床疗效,采用颈椎功能障碍指数(NDI)“头痛问题”Q5评分评价头痛程度。结果所有手术顺利完成,所有患者随访>12个月。患者术后各随访时间点JOA评分较术前显著改善,差异均有统计学意义(P<0.05)。除1例轻度头痛患者术后头痛无缓解,其余患者头痛均不同程度缓解。结论颈椎后路单开门椎管扩大椎板成形术能缓解MCSM合并颈源性头痛患者的临床症状。

Objective To explore the clinical efficacy of posterior single-door laminoplasty for the treatment of multi-segment cervical spondylotic myelopathy(MCSM)with cervicogenic headache.Methods From January 2018 to June 2021,31 patients with MCSM and cervicogenic headache were treated with posterior cervical single-door laminoplasty.At pre-operation and postoperative 1,3,12 months,clinical efficacy was evaluated by the Japanese Orthopedic Association(JOA)score and the intensity of headache was evaluated by the neck disability index(NDI)"headache problem"Q5 score.Results All the operations were successfully completed,and all the patients were followed up for more than 12 months.The JOA scores improved significantly at post-operation compared to pre-operation,all with a statistically significant difference(P<0.05).Except for 1 mild headache patient who had no relief after surgery,all other patients'headache had varying degrees of relief.Conclusion Posterior single-door laminoplasty can alleviate the clinical symptoms of MCSM with cervicogenic headache.