改良单开门椎板成形术应用于多节段脊髓型颈椎病治疗的临床效果

Clinical Effect of Modified Single Door Laminoplasty in the Treatment of Multilevel Cervical Spondylotic Myelopathy

目的:探究改良单开门椎板成形术治疗多节段脊髓型颈椎病患者的临床效果.方法:选取2018年6月-2020年6月锦州市中心医院收治的80例多节段脊髓型颈椎病患者资料进行回顾性分析,根据治疗方式不同将其分为对照组(n=37)和观察组(n=43).对照组采用传统颈椎后路单开门椎板成形术治疗,观察组采用改良单开门椎板成形术治疗.比较2组手术基础指标、疼痛程度、炎症指标、颈椎功能、创伤应激指标水平、术后并发症发生率及临床疗效.结果:观察组手术时间短于对照组,出血量及引流量均少于对照组,但2组比较差异均无统计学意义(P>0.05).术后,观察组并发症发生率9.30%低于对照组的27.03%;观察组治疗总有效率为95.35%,高于对照组的81.08%,组间差异有统计学意义(P<0.05).术后3、6个月,2组疼痛视觉模拟(VAS)评分、颈椎功能障碍指数(NDI)评分均低于术前,且观察组VAS、NDI评分均低于对照组,组间差异有统计学意义(P<0.05).术后,2组白细胞计数(WBC)、中性粒细胞绝对值(NEUT)水平均高于术前,但观察组WBC、NEUT水平均低于对照组,差异有统计学意义(P<0.05).术后,2组皮质醇、C反应蛋白、丙二醛、5-羟色胺水平均高于术前,且观察组上述指标水平均高于对照组,组间差异有统计学意义(P<0.05).结论:采用改良单开门椎板成形术治疗多节段脊髓型颈椎病患者可减轻炎症反应,降低机体创伤应激反应,缓解疼痛,提高手术安全性及临床疗效,促进颈椎功能的恢复.

Objective:To investigate the clinical effect of modified single door laminoplasty in the treatment of multilevel cervical spondylotic myelopathy.Methods:The data of 80 patients with multisegmental cervical spondylotic myelopathy treated in Jinzhou Central Hospital from June 2018 to June 2020 were retrospectively analyzed.According to different treatment methods,they were divided into a control group(n=37)and an observation group(n=43).The control group was treated with traditional posterior cervical single door laminoplasty,the observation group was treated with modified single door laminoplasty.The basic indexes of surgery,pain degree,inflammation index,cervical spine function,traumatic stress index level,postoperative total complication rate and clinical efficacy of the two groups were compared.Results:The operation time of the observation group was shorter than that of the control group,the blood loss and drainage volume were less than those of the control group,but there was no statistical significance between the two groups(P>0.05).After operation,the complication rate of observation group 9.30%was lower than 27.03%of control group,the total effective rate of the observation group was 95.35%higher than 81.08%of the control group,the dfferences were statistically significant between the two groups(P<0.05).At 3 and 6 months after operation,the scores of the pain Visual Analogue Scales(VAS)and Neck Disability Index(NDI)in two groups were lower than those before operation,and scores of VAS and NDI in the observation group were lower than those in the control group,the differences were statistically significant between the two groups(P<0.05).After operation,the levels of white blood cell count(WBC)and neutrophil absolute value(NEUT)in two groups were higher than those before operation,but the levels of WBC and NEUT in the observation group were lower than those in the control group,with statistical significance(P<0.05).After surgery,the levels of cortisol,C-reactive protein,malondialdehyde and 5-hydroxytryptamine in two groups were higher than those before surgery,the above indexes in the observation group were higher than the control group,with statistical significance between the two groups(P<0.05).Conclusion:Modified single door laminoplasty in the treatment of multilevel cervical spondylotic myelopathy can reduce inflammation,reduce traumatic stress,relieve pain,improve surgical safety and clinical efficacy,and promote the recovery of cervical vertebra function.