颈椎后路单开门椎管扩大成形术与颈椎后路双开门椎管扩大成形术治疗多节段压迫性颈脊髓病的效果分析

Effect Analysis of Single Door Versus Double Door Posterior Cervical Expansive Laminoplasty in Treatment of Multi-Segment Compressive Cervical Myelopathy

目的:比较颈椎后路单开门椎管扩大成形术与颈椎后路双开门椎管扩大成形术治疗多节段压迫性颈脊髓病的效果。方法:选取2018年2月—2023年1月北京丰台医院收治的84例多节段压迫性颈脊髓病患者作为研究对象,随机分为单开门组和双开门组,各42例。单开门组采用单开门椎管扩大成形术治疗,双开门组采用双开门椎管扩大成形术治疗。比较两组治疗效果。结果:双开门组手术时间短于单开门组,术中出血量少于单开门组,差异有统计学意义(P<0.001)。术前、术后,两组上肢运动功能、下肢运动功能、感觉功能、膀胱功能评分及总分比较,差异无统计学意义(P>0.05);术后,两组上肢运动功能、下肢运动功能、感觉功能、膀胱功能评分及总分高于术前,差异有统计学意义(P<0.001)。术前、术后,两组颈椎曲度、疼痛评分比较,差异无统计学意义(P>0.05);术后,两组颈椎曲度小于术前,疼痛评分低于术前,差异有统计学意义(P<0.001)。结论:颈椎后路单开门椎管扩大成形术与颈椎后路双开门椎管扩大成形术治疗颈脊髓病均可取得较好效果,但颈椎后路双开门椎管扩大成形术手术时间更短,术中出血量更少。

Objective:To compare the effect of single door versus double door posterior cervical expansive laminoplasty in treatment of multi-segment compressive cervical myelopathy.Methods:A total of 84 patients with multi-segment compressive cervical myelopathy treated at Beijing Fengtai Hospital from February 2018 to January 2023 were selected as the study subjects.They were randomly divided into a single-door group and a double-door group with 42 patients in each group.The single-door group was treated with single door expansive laminoplasty,while the double-door group was treated with double door expansive laminoplasty.The treatment effects of two groups were compared.Results:The operation time in the double-door group was shorter than that in the single-door group,and the intraoperative blood loss in the double-door group was less than that in the single-door group,and the difference was statistically significant(P<0.001).There was no significant difference in the scores of upper limb motor function,lower limb motor function,sensory function and bladder function and total scores between the two groups before and after operation(P>0.05);After operation,the scores of upper limb motor function,lower limb motor function,sensory function and bladder function and total scores in the two groups were higher than those before operation,and the difference was statistically significant(P<0.001).There was no significant difference in cervical curvature and pain scores between the two groups before and after operation(P>0.05);After operation,the cervical curvature in two groups was lower than that before operation,and the pain score in two groups was lower than that before operation,with a statistically significant difference(P<0.001).Conclusion:Both single door and double door posterior cervical expansive laminoplasty can achieve good results in the treatment of cervical myelopathy,but the double door posterior cervical expansive laminoplasty has a shorter operation time and less intraoperative blood loss.