单开门与胶原酶溶盘联合治疗颈髓损伤的临床研究

目的探讨颈后路单开门椎管扩大成形术与胶原酶直视下溶盘术联合治疗外伤性无骨折脱位型颈脊髓损伤的疗效。方法对11例外伤性无骨折脱位型颈脊髓损伤患者行颈后路单开门椎管扩大成形术，然后在直视下将胶原酶注入突出的颈椎间盘，术后平均随访时间为24个月，结合症状、体征、影像学资料，观察手术效果。结果联合治疗有效地缓解了患者的症状、体征。影像学资料显示椎管容积明显增加，突出的间盘缩小。术后6个月平均JOA改善率63．7％。结论联合治疗不仅通过后路单开门扩大了椎管的容积，而且通过溶盘术缓解了颈髓前面突出髓核的压迫，从而取得了较好的治疗效果。单开门椎管扩大成形术和胶原酶溶盘术联合治疗Ⅲ型无骨折脱位型颈脊髓损伤是一种可行的手术方法。

Clinical Observation of Posterior Cervical Spine Canal Expansive Open-door Laminoplasty and Collagenase Chemonucleolysis in Cervical Spine Injuries

Objective To study the clinical application and therapeutic effect of posterior cervical spine canal expansive open-door laminoplasty and collagenase chemonucleolysis in cervical spine injuries without fracture and dislocation. Methods Because of being cervical spine injuries without fracture and dislocation, 11 patients had been underwent posterior cervical spine canal expansive open-door laminoplasty and collagenase chemonucleolysis with average follow-up of 24 months. Then evaluated the therapeutic effect combined with the patients＇ symptom,physical sign and imaging data. Results The therapeutic alliance had been alleviated the sufferersI symptom and physical sign effectively,and the imaging showed the projected discs contracted. Conclusion The therapeutic alliance had been not only extended the vertebral canal by posterior cervical spine canal expansive open-door laminoplasty,but also relieved the discs＇ oppression by collagenase chemonucleolysis. Therefore,it reached a good therapeutic effect.