颈椎棘突纵切双开门扩大植骨成形术后椎管面积与神经功能改善的2年随访

Two year follow-up of vertebral canal area and improvement of nervous function after double door laminoplasty by slitting spinous process of cervical vertebra

目的:观察应用颈椎棘突纵切双开门扩大植骨成形术后脊髓型颈椎病患者神经功能改善的临床疗效。方法:采用颈椎棘突纵切双开门扩大植骨成形术治疗35例脊髓型颈椎病患者,术前术后均采用JOA评分评估神经功能。结果:35例患者术后均获得26～56个月(平均40.6个月)随访。末次随访JOA评分改善率:优10例(28.6%),良13例(37.1%),一般8例(22.9%),差4例(11.4%)。JOA评分为9～17分,平均(12.6±3.5)分,与术前JOA评分情况比较差异有显著性意义(P<0.01)。神经功能改善率为88.6%,优良率为65.7%。结论:颈椎棘突纵切双开门扩大植骨成形术对脊髓型颈椎病是一种安全有效的手术方法,患者术后椎管面积与神经功能改善状况良好,效果明显。

AIM:To observe the clinical effects of double door laminoplasty in the i mprovement of nervous function of patients with cervical spondylotic myelopathy by slitting spinous process of cervical vertebra. METHODS:Thirty five patients with cervical spondylotic myelopathy underwent double door laminoplasty by slitting spinous process of cervical vertebra.Preoperative and postoperative nervous functions were assessed using a scoring system proposed by Japanese Orthopadic Association (JOA score). RESULTS:The follow up lasted 26 to 56 months(average follow up 40.6 months).The average JOA scores were 12.6±3.5(9-17 scores) at the lastest follow up.There were significant differences between preoperative and postoperative JOA scores(P< 0.01). Of these 35 patients,10 patients(28.6%) had excellent results,13(37.1%) good,8(22.9%) fair and 4(11.4%) poor. CONCLUSION:Double door Laminoplasty by slitting spinous process of cervical vertebra is a reliable and safe procedure for the treatment of cervical spondylotic myelopathy.It is obviously effective in the area of vertebral canal and the improvement of nervous function of patients.