颈椎单开门椎板成形术中铰链侧断裂后采用新型棘突悬吊法固定的临床疗效

目的 探讨颈椎单开门椎板成形术中铰链侧断裂后采用新型棘突悬吊法固定的临床疗效.方法 2016年6月—2019年4月,海军军医大学长征医院采用ARCH钢板并单节段椎板成形术治疗多节段颈椎椎管狭窄症患者,术中发生铰链侧椎板断裂(≤2个节段)30例.早期发生铰链侧椎板断裂的15例患者未行任何处理(对照组),后期的15例患者采...

Clinical efficacy of new spinous process suspension method for hinge side fracture in single-door cervical laminoplasty

Objective To investigate the clinical efficacy of a new spinous process suspension method for hinge side fracture in single-door cervical laminoplasty.Methods From June 2016 to April 2019,ARCH plate and single-door cervical laminoplasty were used in the treatment of multi-segment cervical spinal stenosis in Changzheng Hospital Affiliated to Navy Medical University.During the operation,30 cases of hinge side lamina fracture(≤2 segments)occurred.In the early stage,15 patients with hinge side lamina fracture did not receive any treatment(control group),and in the later stage,15 patients were fixed with new spinous process suspension method(experiment group).The operation time,intraoperative blood loss,postoperative drainage volume,and visual analogue scale(VAS)score,Japanese Orthopaedic Association(JOA)score,neck disability index(NDI),C2-7 Cobb’s angle,cervical curvature and cervical range of motion(ROM)at pre-operation and postoperative 3 months,and postoperative complications(axial pain,infection,C5 nerve root palsy,and lamina nonunion at 6 months after operation)were recorded and compared between the 2 groups.Results All the patients were followed up for 10-35 months,with an average of 20 months.The operation time and intraoperative blood loss of the control group were less than those of the experiment group,all with a statistical significance(P<0.05).The VAS score,JOA score,NDI,C2-7 Cobb’s angle,cervical curvature and ROM of the 2 groups were significantly improved at postoperative 3 months compared with those at pre-operation,all with a statistical significance(P<0.05).The VAS score,JOA score,NDI and cervical ROM at postoperative 3 months in the experiment group were better than those in the control group,and the differences were statistically significant(P<0.05).There were 7 cases of axial pain in the experiment group,and 1 in the control group,and the difference was statistically significant(P<0.05).There were 6 cases with lamina nonunion at 6 months after operation in the control group and 3 in the experiment group,and the difference was not statistically significant(P>0.05).Conclusion The new spinous process suspension method for hinge side fracture in single-door cervical laminoplasty is more conducive to reduce the incidence of postoperative cervical dysfunction,preserve the cervical ROM and reduce the occurrence of axial pain.