中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (4): 589-592.doi: 10.3969/j.issn.1673-8225.2012.04.004

• 数字化骨科 digital orthopedics • 上一篇    下一篇

颈后路个体化精确椎管横径测量在椎管扩大成形治疗椎板定位中的意义☆

张德强，杨  群，吴春明，马  凯   

  1. 大连医科大学附属第一医院骨科，辽宁省大连市 116011
  • 收稿日期:2011-07-28 修回日期:2011-10-20 出版日期:2012-01-22 发布日期:2014-04-04
  • 通讯作者: 杨群，硕士，教授，大连医科大学附属第一医院骨科，辽宁省大连市 116011 yangqun@medmail.com.cn
  • 作者简介:张德强☆，男，1973年生，辽宁省营口市人，汉族，2003年苏州大学医学院毕业，博士，副教授，主要从事脊柱外科研究。 zdq707@163.com

Treatment for cervical spondylotic myelopathy with laminoplasty based on individual accurate transverse diameter of the spinal canal

Zhang De-qiang, Yang Qun, Wu Chun-ming, Ma Kai   

  1. Department of Orthopedics, the First Affiliated Hospital of Dalian Medical University, Dalian  116011, Liaoning Province, China
  • Received:2011-07-28 Revised:2011-10-20 Online:2012-01-22 Published:2014-04-04
  • Contact: Yang Qun, Master, Professor, Department of Orthopedics, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China yangqun@medmail.com.cn
  • About author:Zhang De-qiang☆, Doctor, Associate professor, Department of Orthopedics, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China zdq707@163.com

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摘要：

背景：颈后路单开门椎管扩大成形传统方法采用术中解剖标志定位，定位较模糊，且容易受患者个体差异及术者经验的影响。
目的：观察颈后路个体化精确椎管横径单开门椎管扩大成形治疗颈椎病的疗效。
方法：2006-01/2009-12共施行颈后路个体化精确椎管横径单开门椎管扩大成形治疗119例，对单开门术式进行了部分改进，行个体化椎管横径测量法的单开门椎管扩大成形治疗。观察临床疗效并比较治疗前后和随访时的JOA评分和目测类比评分。
结果与结论：共112例患者获得随访，随访时间15~53个月。JOA评分治疗后6个月、末次随访时与治疗前比较显著升高(P < 0.01)。末次随访时疗效分级，优57例，良43例，优良率89.3%。目测类比评分治疗后6个月、末次随访时与治疗前比较显著下降(P < 0.01)。仅有3例患者治疗后出现C5神经根麻痹症状，发生率为2.67%。提示颈后路个体化精确椎管横径单开门椎管扩大成形治疗颈椎病减压彻底，脊髓后移充分，手术方法简单规范，治疗后C5神经根麻痹和颈肩痛症状发生较少。

关键词: 椎板切除, 颈椎病, 个体化, 横径测量, 治疗效果

Abstract:

BACKGROUND: Traditional methods of posterior open-door laminoplasty use intraoperative anatomical landmark location, the location is ambiguous and is easy to be influenced by individual difference of patients, as well as the experience of the surgeon.
OBJECTIVE: To evaluate the results of treatment for cervical spondylotic myelopathy with laminoplasty based on individual accurate transverse diameter of the spinal canal.
METHODS: From January 2006 to December 2009, a total of 119 patients with cervical spondylotic myelopathy were treated with laminoplasty based on individual accurate transverse diameter of the spinal canal. The single-door laminoplasty was improved, and underwent with the laminoplasty based on individual accurate transverse diameter of the spinal canal. The clinical outcome was observed, and the Japanese Orthopaedic Association score and visual analogue scale score prior to and post operation and during follow-up were compared.
RESULTS AND CONCLUSION: 112 patients were followed-up of average 39 months (range, 15-53 months). Compared with the preoperative, the JOA score of the 6 months postoperative and the last follow-up were significantly increased (P < 0.01). To classify the therapeutic effect in the last follow-up, 57 patients got excellent and 43 got good and the sum was 89.3%. Compared with preoperative, the visual analogue scale score of the 6 months postoperative and the last follow-up were significantly decreased (P < 0.01). Only three patients suffered from the palsy of C5 nerve root, and the incidence rate was 2.67%. The laminoplasty based on individual accurate transverse diameter of the spinal canal is proved effective in treating cervical spondylotic myelopathy. The method manage to thoroughly decompress and shift backward the spinal cord which benefits on relief of cervical/shoulder pain, lower rate of the palsy of C5 root. And it is practical and easy to be standardized. 

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