Twinfix锚钉改良单开门颈椎管扩大成形术治疗多节段脊髓型颈椎病的早期临床疗效

目的评价Twinfix锚钉改良单开门颈椎管扩大成形术治疗多节段脊髓型颈椎病的早期临床疗效。方法选择2008年3月～2011年3月四川省眉山市人民医院采用Twinfix锚钉改良单开门颈椎管扩大成形术治疗多节段脊髓型颈椎病28例（改良组）,与同期传统单开门手术治疗的31例（传统组）进行疗效分析比较,记录日本骨科协会（JOA）评分（17分法）、颈椎总活动度（ROM）及轴性症状。结果术后随访12～36个月,改良组平均24.3个月,传统组平均24.5个月。改良组术前JOA评分（8.13±0.47）分,术后（15.09±0.53）分,改善（6.95±0.68）分,传统组术前JOA评分（8.09±0.53）分,术后（14.94±0.47）分,改善（6.84±0.49）分,两组间改善比较差异无统计学意义（P〉0.05）。改良组手术前后ROM减少（5.42±1.89）度,传统组手术前后ROM减少（8.67±2.39）度,组间差异有统计学意义（P〈0.05）。改良组术后发生轴性症状8例,传统组术后发生轴性症状20例,组间差异有统计学意义（P〈0.05）。结论 Twinfix锚钉改良单开门颈椎管扩大成形术是治疗多节段脊髓型颈椎病的一种简便安全的方法,能较大程度保留颈椎活动度,能有效减少术后轴性症状的发生,早期疗效较满意。

Early clinical efficacy of modified expansive open-door laminoplasty using Twinfix anchor, for the treatment of multi-segmental cervical spondylotic myelopathy

Objective To evaluate the early clinical efficacy of modified expansive open-door laminoplasty using Twinfix anchor for the treatment of multi-segmental cervical spondylotic myelopathy. Methods From March 2008 to March 2011, 28 cases with multi-segment cervical spondylotic myelopathy People＇s Hospital of Meishan City were treated by modified expansive open-door laminoplasty using Twinfix anchor, and 31 cases were treated by traditional expansive open-door laminoplasty. They were analyzed retrospectively using the Japanese Orthopedic Association （JOA） scale, ranges of motions （ROM） of cervical vertebra and Axial symptoms （AS）. Results These cases were followed up 12-36 months （average 24.3 in the modified group and 24.5 in the traditional group）. The average preoperative JOA score of the modified group was （8.13±0.47） and postoperative JOA score was （15.09±0.053）, with an average improvement of （6.95±0.68）, while the average preoperative JOA score of the traditional was （8.09±0.53） and postoper- ative JOA score was （14.94±0.47）, with an average improvement of （6.84±0.49） （P 〉 0.05）. The decrease of ROM between the preoperative and the postoperative in the modified group was （6.95±0.68） and in the traditional group was （8.67±2.39） （P 〈 0.05）. There were 8 cases with AS in the modified group and 20 in the traditional （P 〈 0.05）. Conclusion The modified expansive open-door laminoplasty using Twinfix anchor for the treatment of multi-segmental cervical spondylotic myelopathy that can keep the ROM greatly and reduce the incidence of postoperative AS effectively, is a simple and reliable, and the early clinical efficacy is satisfactory.