单开门棘突重建颈椎管扩大成形术治疗无骨折脱位型颈脊髓损伤

目的 探讨单开门棘突重建颈椎管扩大成形术治疗无骨折脱位型颈脊髓损伤的疗效。方法 无骨折脱位型颈脊髓损伤15例，均行单开门棘突重建颈椎管扩大成形术。采用JOA、Frankel分级及影像学进行疗效评价。结果 平均随访2年5个月，JOA评分术后改善率为35．83％，Frankel分级B→C1例，C→C2例，C→D7例，D→D2例，D→E3例。影像学检查示15例颈椎生理屈度正常，未发现有再“关门”及不稳定现象。结论 单开门棘突重建颈椎管扩大成形术由于重建了颈后方韧带复合体，对于改善和维持颈椎的生理曲度、稳定性方面具有重要的临床意义。

Treatment of cervical spinal cord injury without fracture or dislocation by unilaterally-open expansive laminoplasty and reconstruction of spinous process

Objective To report the results of treatment of cervical spinal cord injury without fracture or dislocation by unilaterally open expansive laminoplasty and reconstruction of spinous process. Methods 15 cases of cervical spinal cord injury without fracture or dislocation were treated with the above mentioned method. 9 of them were male and 6 were female, with an average age of 50 years old. The results were evaluated with JOV recovery rating and Frankel scoring system and radiographic examinations. Results The 15 cases were followed up for an average of 2 years and 5 months. Their JOA recovery rate was 35.83%. According to Frankel scoring system, 1 case improved from B to C, 2 cases from C to C, 7 cases from C to D, 2 cases from D to D, and 3 cases from D to E. The radiographic examinations showed that the physiological flexion of cervical spine was normal in all the 15 cases and no instability of the cervical spine or reclosed open door was found. Conclusion Unilaterally open expansive laminoplasty and reconstruction of spinous process for cervical spinal cord injury are good and stable. To reconstruct spinous process with muscle pedicle may be an effective measure to prevent cervical deformity and instability after expansive laminoplasty.