锚定钉在单开门颈椎管扩大成形术中的应用

目的评价锚定钉在单开门颈椎管成形术（Unilateral open-door laminoplasty）中的临床应用价值。方法 2009年1月-2010年6月,26例因颈椎病行ELAP手术的患者纳入本次研究。其中12例用锚定钉进行＂门轴＂侧固定的患者为研究组,另14例采用传统缝线悬吊＂门轴＂的患者设定为对照组。随访12个月,对手术时间、术中出血量、神经功能改善情况及轴性症状等进行统计分析。结果术后12个月随访时两组间比较：手术时间、出血量、JOA评分增长率等均无差别,轴性症状发生率锚定钉组明显低于对照组（P〈0.01）,研究组较对照组提前下床活动（P〈0.01）。结论锚定钉的使用避免了传统ELAP手术对于门轴侧小关节囊和椎旁肌肉的缝合干扰,有效降低了术后轴性症状的发生,利于早期下床活动。

Clinical Application of Anchor Nail in Cervical Laminoplasty

Objective To evaluate the value of unilateral open-door laminoplasty with anchor nail in clinical application for cervical spondylosis. Methods 26 patients with cervical spondylosis were included in unilateral open- door laminoplasty during the period from January 2009 to June 2010 and assigned to one of two treatment groups： 12 patients in the investigational group underwent unilateral open-door laminoplasty with anchor nail on the side of bone hinge~ 14 patients in the control group underwent unilateral open-door laminoplasty with orthodox suture on the same side. All available data was statistically analyzed which inclouded operative time, Intraoperative blood loss, neurological improvement and Axial syndrom and so on. Results At 12 months postoperative period there was no significant difference in operative time, Intraoperatlve blood loss,and Japanese Orthopaedic Association（JOA） Score Recover Rate. Axial syndrom in the investlgational group was significantly lower at follow-up timepoint compared with the control group（P〈0.01）. All patients in the investigational group was earlier activity than those in the control group（P〈0.01）. Conclusions The investigational group with anchor nail was used to avoid affecting small articular capsules and paravertebral muscles at the hinge side, which effectively decreased Postoperative axial syndrome and benefited activity in the early period.