单开门椎管扩大成形术治疗脊髓型颈椎病疗效分析

Evaluation of the Clinical Outcome in Expansive Open-door Laminoplasty for Cervical Spondylotic Myelopathy

目的 评价后路单开门椎管扩大成形术治疗脊髓型颈椎病的疗效及影响因素。方法 对 4 7例脊髓型颈椎病行单开门椎管成型术 ,平均随访时间 39 2个月 ,手术前后应用JOA评分法 ,对脊髓功能的改善情况进行对比分析。结果 病程小于 6个月者 2、 3年改善率分别为 6 8 0 6 %、 6 9 2 1 % ;病程超过 6个月者 2、 3年改善率分别为 6 1 80 %、 6 2 4 3%。术后 2年的改善率与术前JOA评分呈负相关性 (r=- 0 30 )。结论 单开门椎管扩大成形术后疗效肯定 ,术后缓解率同病程长短以及术前脊髓功能受损程度有关 ,脊髓功能恢复在

Objective To evaluate the clinical outcome and prognostic factors in the patients in whom expansive open-door laminoplasty(ELAP) were performed for cervical spondylotic myelopathy(CSM).Methods Results in 47 patients who underwent ELAP for cervical spondylotic myelopathy were investigated.The mean follow up period was 39 2 months.The pre- and postoperative neurological evaluation was performed using the Japanese Orthopedic Association(JOA) Scale for functional assessment of myelopathy.Results The recovery rates for the patients with symptom duration less than 6 months were 68 06% and 69 21% in 2 and 3 years after operation respectively.And the recovery rates for those with symptom duration more than 6 months were 61 80% and 62 43% in 2 and 3 years after operation respectively.The 2 years mean recovery rates were negatively correlated with the preoperative JOA score(r=-0 30).Conclusion Expansive open-door laminoplasty shows a promising effect on clinical outcome in the patients with CSM.The postoperative recovery rate is related to the duration of the symptoms and the functional condition of spinal cord.The mean recovery rate is not change markedly 2 years after the operation.