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"锚定法"改良单开门椎管成形术及其临床应用
引用本文:孙宇,张凤山,潘胜发,王少波,李迈,张立."锚定法"改良单开门椎管成形术及其临床应用[J].中国脊柱脊髓杂志,2004,14(9):517-519.
作者姓名:孙宇  张凤山  潘胜发  王少波  李迈  张立
作者单位:北京大学第三医院骨科,100083,北京市
摘    要:目的评价“锚定法”改良单开门椎管成形术的疗效。方法对129例颈椎病患者常规行后正中入路单开门椎管成形术,在门轴一侧的侧块上选择钻孔点,采用Magerl方法置入直径为3.5mm、长度10~12mm的钛质松质骨螺钉。先将粗丝线系在螺钉的根部,螺钉置入侧块后将丝线一端经棘突根部的预穿孔穿过,开门后拉紧丝线并打结,使椎板保持在开门状态。术后颈围领保护2周。结果平均随访14个月(6~18个月)。术前平均JOA评分7.8分、40分法评分14.5分,术后平均JOA评分15.5分、40分法评分35.5分。术后2个月时颈部疼痛、僵硬感和活动受限者轻度84例、中度32例、重度13例。术后6个月时仅23例仍然有轻度颈部疼痛、僵硬感和活动受限。未见螺钉松动和再“关门”现象。结论“锚定法”改良单开门椎管成形术操作简单、维持“开门”效果好。术后患者颈部症状恢复快,早期效果满意。

关 键 词:颈椎病  椎板成形术  轴性症状
文章编号:1004-406(2004)-09-0517-03
修稿时间:2004年3月8日

The clinical application of a modified open door laminoplasty using anchor method
SUN Yu,ZHANG Fengshan,PAN Shengf,et al.The clinical application of a modified open door laminoplasty using anchor method[J].Chinese Journal of Spine and Spinal Cord,2004,14(9):517-519.
Authors:SUN Yu  ZHANG Fengshan  PAN Shengf  
Institution:SUN Yu,ZHANG Fengshan,PAN Shengfa,et al Department of Orthopedics Surgery,Peking University Third Hospital,Beijing,100083,China
Abstract:Objective:To evaluate the clinical outcome of modified open door laminoplasty using anchor method.Method:Posterior midline approach.Magerl technique was used for the insertion of lateral mass screw on hinge side.A surgical suture was tethered to the top of a titanium cancellus screw with 3.5mm in diameter and 10~12mm in length.The screw was inserted to the lateral mass and each lamina was suspended through the hole in the base of spinous process to the screw on the corresponding lateral mass to remain the door in the opening position.Soft collar protection was applied for two weeks after the operation.Result:129 cases of cervical spondylotic myelopathy were included in this study.The mean follow up was 14 months (6 to 18 months).The average pre-OP JOA score was 7.8 and post-OP JOA score was 15.5.84 cases had slight axial symptoms like neck pain,stiffness and restriction of neck movement two months after the operation.32 cases had moderate and 13 cases had severe axial symptoms.There were only 23 cases experienced slight axial symptoms six months after the operation.There was no case of screw loosening and door re-closure.Conclusion:This modified open door laminoplasty using anchor method has the advantages of easy performing,good maintaining of elevated lamina,less neck symptoms and early commencing of mobilization.
Keywords:Cervical spondylosis  Laminoplasty  Axial symptoms
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