Centerpiece钛板在颈椎单开门椎管扩大成形术中的应用

目的探讨颈椎单开门椎管扩大成形术结合Centerpiece钛板固定术后的临床疗效。方法回顾分析2009年2月~2012年12月无锡市中医医院脊柱科应用颈椎单开门治疗的颈椎椎管狭窄症患者资料30例,其中Centerpiece钛板固定16例(钛板组),传统丝线悬吊14例(悬吊组)。观察2组患者术后神经功能改善情况;比较2组患者术前、术后2个月及末次随访时颈椎活动度、颈椎椎管矢状径、颈椎椎管横截面积。比较术后2个月及末次随访时开门角度的变化。结果经日本骨科学会(Japanese Orthopaedic Association,JOA)评分,2组术后2个月及末次随访与术前比较,差异均有统计学意义(P<0.01)。2组患者颈椎活动度术前与术后2个月及末次随访相比,差异均无统计学意义。椎管矢状径、开门角度及椎管横截面积在末次随访与术后2个月比较中,钛板组差异无统计学意义;悬吊组差异有统计学意义(P<0.01)。结论颈椎后路单开门结合Centerpiece钛板固定可良好保持开门椎板的稳定状态,维持开门角度以扩大椎管的容积,而传统丝线悬吊组椎板的稳定性在随访期内有所下降。

Centerpiece plating in unilateral open-door cervical expansive laminoplasty

Objective To evaluate the clinical result of unilateral open-door cervical expansive laminoplasty fixed by centerpiece plate for cervical spondylosis. Methods From February 2009 to December 2012, 30 patients with multi-segmental cervical spinal stenosis were treated with unilateral open-door cervical expansive laminoplasty of whom 16 cases underwent cervical single open-door and plate fixation (Group Plate); 14 cases underwent cervical single open-door laminoplasty and silk suture fixation (Group Silk). To observe the neurofunctional amendment of the 2 gorups. The Japan Orthopaedic Association(JOA) score, the cervical range of motion (ROM), the sagittal diameter (AP) and the cross sectional area of upper vertebral canal were observed at peroperation, 2 months postoperation and the final follow-up. The open angle was observed at 2 months postoperation and the final follow-up. Results JOA score of 2 months postoperation and the final follow-up of 2 groups were significantly different from that of the preoperative (P<0.01). Cervical ROM of 2 months postoperation and the final follow-up of 2 groups were not significantly different from that of the preoperative. There was no significant differences of the sagittal diameter (AP), the cross sectional area and the open angle between 2 months postoperation and the final follow-up in Group Plate.In contrast,there were significantly different in Group Silk (P<0.01). Conclusion The centerpiece plate used to fix the lamina in unilateral open-door cervical expansive laminoplasty can make the fixation stable,maintain the door-open to enlarge spinal canal volume, however the stability of traditional suture fixation is decreased in the follow-up.