大Z形开门椎管扩大成形术治疗27例脊髓型颈椎病

背景]观察颈椎后路改良大Z形交叉式单开门椎管扩大成形术治疗脊髓型颈椎病的疗效.病例报告]对27例脊髓型颈椎病患者实施大Z形交叉式单开门椎管扩大成形术,通过术前及术后影像学观察及用JOA 17分法进行近期疗效分析.平均随访14个月,JOA评分从术前平均8.4分改善到术后平均13.7分.影像学检查示术前22例颈椎前突型患者在术后随访时3例转变为直线型;术前5例颈椎直线型患者在术后随访时仍均保持直线型.术后颈椎前后活动度与轴性疼痛的发生相关.讨论]采用改良大Z形交叉式单开门椎管扩大成形术治疗脊髓型颈椎病,具有减压彻底、椎管扩大充分、防止再关门等优点,是简便、安全且有效的方法.

Operative procedure of Z-open-door expansive laminoplasty for 27 cases of cervical spondylotic myelopathy

BACKGROUNDTo investigate the therapeutic effects of cervical spondylotic myelopathy(CSM) by expansive Z-open-door laminoplasty.CASE REPORTS27 cases of CSM were operated with expansive Z-open-door laminoplasty,and followed up in an average of 14 months.The therapeutic effects were observed by imaging examination and the method of JOA scores in before and after operation.The JOA scores of the cases were improved as 13.7 after operation,and that were 8.4 before operation.Imaging examination showed that 3 cases of the front to line type were changed into the straight line type,5 cases of the straight line type still keeped the straight line type,and none changed into the back to line type after operation.There were significant statistical discrepancy between the range of motion of cervical vertebra and pain.DISCUSSIONExpansive Z-open-door laminoplasty for CSM can decompress thoroughly and expansive laminoplasty adequately,and accordingly prevent to close door again.It is a simple,safe and effective method.