共查询到20条相似文献,搜索用时 15 毫秒
1.
目的探讨短节段侧块螺钉内固定联合“锚定法”后路单开门椎管扩大椎板成形术治疗不稳定性多节段脊髓型颈椎病(MCSM)的疗效。方法回顾性分析2015年1月—2016年6月接受短节段侧块螺钉内固定联合“锚定法”后路单开门椎管扩大椎板成形术治疗的35例不稳定性MCSM患者临床资料,记录手术时间、术中出血量、术后引流量、住院时间及并发症发生情况,在手术前后影像学图像上测量C2~7 Cobb角、颈椎活动度(ROM)、椎管矢状径及椎管横截面积,并计算椎管扩大率。采用日本骨科学会(JOA)评分及其改善率评价术后神经功能改善情况,采用疼痛视觉模拟量表(VAS)评分及颈椎功能障碍指数(NDI)评价患者疼痛及功能改善情况。结果所有手术均顺利完成。患者随访18个月;手术时间(93.0±21.5)min,术中出血量(189.5±35.1)mL,术后引流量(169.4±15.6)mL,住院时间(8.5±0.8)d。术后C2~7 Cobb角、椎管矢状径、椎管横截面积、JOA评分、VAS评分及NDI较术前明显改善,差异均有统计学意义(P<0.05);椎管扩大率为(72.6±11.5)%,JOA评分改善率为(81.5±5.3)%。术后颈椎ROM与术前相比差异无统计学意义(P>0.05)。术后发生颈部轴性疼痛6例,C5神经根麻痹1例。所有患者未发生螺钉及铆钉松动、脱落,扩大的椎管再关闭现象或其他并发症。术后影像学资料显示骨融合良好。结论短节段侧块螺钉内固定联合“锚定法”后路单开门椎管扩大椎板成形术治疗MCSM能明显改善患者脊髓功能,维持颈椎曲度及稳定性,疗效确切。 相似文献
2.
目的 探讨和分析双开门侧块固定植骨技术治疗多节段脊髓型颈椎病的优点和疗效.方法 自2000年7月-2005年2月,对13例多节段脊髓型颈椎病患者,行颈椎后入路双开门椎板成形术加C4-C6双侧颈椎侧块钉棒系统固定,C3-C7椎板长条骨块植骨.术前JOA评分,0~4分1例,5~8分8例,9~12分4例,平均8.8分.随访1.5~6年,平均3.2年.按手术后JOA评分的改善率和失稳并发症的发生率来评定患者手术疗效.结果 术后11例(84.6%)患者神经功能得到不同程度的改善,其中优3例,良6例,优良率达到69.2%;无效2例(15.4%).植骨融合率100%.无1例颈肩轴向痛、C5神经根麻痹、后凸畸形以及开门后再关门现象发生.结论 双开门侧块固定植骨技术不仅能使脊髓获得充分减压,还能增强颈椎的稳定和促进融合,大大减少了后路椎板成形术后颈椎失稳所带来的并发症. 相似文献
3.
4.
颈椎侧块钢板在脊髓型颈椎病治疗中应用 总被引:2,自引:1,他引:1
目的 对15例脊髓型颈椎病患者行后入路椎管减压、椎板成型术的同时使用颈椎侧块钢板固定,探讨和分析该手术方法的优点和手术治疗效果。方法 从自2000年3月—2002年12月,对15例脊髓型颈椎病患者(术前颈椎MR显示有三个节段颈椎椎间盘水平病变并有黄韧带增厚突入椎管),行颈椎后入路双开门椎板成型术加双侧颈椎侧块钢板固定。按JOA评分法评定患者手术前后恢复情况。结果 本组患者男10例,女5例,随访5个月—1年2个月,平均9个月,术后2—7天(平均3.5天)可戴颈围坐起,颈围外固定时间12周,融合时间3—5个月,(平均为3.5个月),术后JOA评分明显提高,所有病人无术中血管、神经根损伤,无植骨不愈合,无内固定断裂。结论 行颈椎后入路双开门椎板成型术联合应用颈椎侧块钢板固定,从后方扩大椎管容积,对脊髓进行减压,辅助以侧块钢板对减压后的颈椎行即时的稳定的固定,增加后方所植髂骨的融合成功率,大大地减少颈椎术后后突畸形发生和术后卧床并发症的发生率。 相似文献
5.
单开门椎管扩大椎板成形术联合侧块螺钉治疗脊髓型颈椎病伴颈椎不稳 总被引:1,自引:1,他引:0
目的:探讨单开门椎管扩大椎板成形术联合侧块螺钉治疗脊髓型颈椎病伴颈椎不稳的疗效。方法:2010年3月至2012年10月,采用单开门椎管扩大椎板成形术联合侧块螺钉治疗脊髓型颈椎病伴颈椎不稳患者25例,其中男18例,女7例;年龄57~68岁,平均57岁。记录术前及末次随访时的JOA评分,对患者临床症状改善进行分析。同时记录Cobb角及颈椎活动度,分析颈椎退变程度。结果:33例患者均获随访,时间18~36个月,平均25.6个月。出现脑脊液漏1例,切口脂肪液化1例,C5神经根麻痹4例,JOA评分由术前的5.2±2.1增加至末次随访时的11.3±2.4(P0.05),Cobb角由术前的(6.5±3.4)°提升至末次随访时的(13.2±4.9)°(P0.05)。颈椎活动度由术前的(30.4±9.2)°下降至末次随访时的(26.5±8.7)°(P0.05)。结论:单开门椎管扩大椎板成形术联合侧块螺钉治疗脊髓型颈椎病伴颈椎不稳疗效良好,具有适用范围广、牢固等优点,但要减少并发症的发生。 相似文献
6.
目的 :探讨颈椎后路改良单开门椎管扩大成形术治疗多节段脊髓型颈椎病的临床效果。方法 :回顾性分析2013年6月~2015年12月采颈椎后路单开门椎管扩大成形术治疗并获得随访的多节段脊髓型颈椎病患者,均采用相同的微型钛板固定单开门椎板,其中21例(男17例,女4例,年龄66.2±10.0岁)采用改良单开门椎管扩大成形术(改良组),39例(男36例,女3例,年龄57.3±10.5岁)采用传统单开门椎管扩大成形术(传统组),收集两组患者手术时间、术中出血量、术后住院时间、手术费用,随访两组患者神经功能改善情况、颈椎曲度、颈椎曲度指数、颈椎活动度及轴性症状等,并进行比较。结果:两组患者性别、年龄、病程、手术时间、术中出血量、术后住院时间均无显著性差异(P0.05),两组手术费用比较有显著性差异,改良组平均手术费用明显低于传统组(P0.05)。术后随访12~24个月,术后12个月两组患者均达到骨性融合,两组神经功能均明显改善,JOA评分改善率改良组为(60.46±9.65)%,传统组为(46.41±24.33)%,两组比较无显著性差异(P0.05)。改良组术后12个月时颈椎曲度丢失4.7°±1.9°,颈椎曲度指数丢失(3.09±.14)%,颈椎活动度丢失7.3°±2.3°;传统组颈椎曲度丢失8.9°±5.6°,颈椎曲度指数丢失(6.27±3.42)%,颈椎活动度丢失13.0°±3.9°,两组比较均有显著性差异(P0.01)。改良组术后出现轴性疼痛症状患者3例,传统组为19例,两组比较有显著性差异(P0.01)。随访期间两组均无再关门发生,两组均无钛板、螺钉松动移位。结论:与颈椎后路传统单开门椎管扩大成形术相比,改良单开门椎管扩大成形术在获得良好神经减压效果的同时,可减少手术费用,降低术后颈椎轴性症状的发生率,有利于颈椎曲度和颈椎活动度的维持。 相似文献
7.
Huang RC Girardi FP Poynton AR Cammisa Jr FP 《Journal of spinal disorders & techniques》2003,16(2):123-129
This is a retrospective review of 32 patients with multilevel cervical myelopathy treated by laminectomy and lateral mass plate fusion. The prognosis of surgically treated myelopathy is evaluated as well as prognostic factors for recovery of myelopathy. Diagnoses included cervical spondylosis or ossification of the posterior longitudinal ligament. Final follow-up was at 15.2 months (mean) postoperatively. Myelopathy was graded preoperatively and postoperatively by the system of Nurick. All patients had preoperative radiographs and magnetic resonance imaging (MRI). The presence of abnormal T2-weighted MRI signal (myelomalacia) was noted. Postoperative studies included flexion-extension radiographs to assess fusion and MRI to evaluate decompression of neural elements and resolution of myelomalacia. Severity of preoperative Nurick myelopathy, presence of myelomalacia, and age were evaluated as potential prognostic indicators for surgically treated myelopathy. Mean Nurick score improved from 2.6 (range 1-4) to 1.8 (range 0-3) postoperatively (p < 0.0001). Twenty-two patients (71%) had improvement in Nurick grade of at least one point, and nine showed no improvement. No patients had deterioration of Nurick grade. Preoperative myelomalacia was noted in 15 (47%) patients, and all 15 had residual myelomalacia postoperatively. Severe myelopathy, age, and myelomalacia had no prognostic value for improvement of myelopathy. Complications included pseudarthrosis (3%), wound infection (9%), and transient C5 palsy (6%). This study demonstrates excellent outcomes from laminectomy and fusion in multilevel cervical myelopathy. A high rate of improvement of myelopathy was observed, neurologic deterioration did not occur, and complication rates were low. Severe myelopathy and myelomalacia on preoperative MRI had no prognostic value. 相似文献
8.
[目的]探讨颈椎前路椎间盘切除椎间融合器融合术加颈椎后路单开门椎管扩大成形术治疗脊髓型颈椎病在临床上的应用价值。[方法]应用Cervical Cage行颈椎前路椎间盘切除椎间融合术,同时,颈椎后路行单开门椎管扩大成形术11例,平均随访6个月。按40分法和JOA评分对手术前后脊髓功能进行评分,并测量颈椎术前术后前柱高度及椎管宽度和进行相关性分析.[结果]颈椎前路椎间盘切除椎间融合器融合术加颈椎后路单开门椎管扩大成形术,明显改善脊髓型颈椎病的脊髓功能。40分法平均37分,改善率83%;JOA评分16.5分,改善率91%;前柱高度平均增加1.28mm;椎管宽度平均增加2.22mm。[结论]颈椎前路椎间盘切除椎间融合器融合术加颈椎后路单开门椎管扩大成形术,有效恢复了颈椎前柱高度、增加椎管宽度,明显改善了脊髓型颈椎病的脊髓功能。 相似文献
9.
Dong-Ho Lee Jae Hwan Cho Chang Ju Hwang Choon Sung Lee Chunghwan Kim Jung-Ki Ha 《The spine journal》2018,18(3):414-421
Background Context
Conventional laminoplasty is useful for expanding a stenotic spinal canal. However, it has limited use for the decompression of accompanying neural foraminal stenosis. As such, an additional posterior foraminotomy could be simultaneously applied, although this procedure carries a risk of segmental kyphosis and instability.Purpose
The aim of this study was to elucidate the long-term surgical outcomes of additional posterior foraminotomy with laminoplasty (LF) for cervical spondylotic myelopathy (CSM) with radiculopathy.Study Design/Setting
A retrospective comparative study was carried out.Patient Sample
Ninety-eight consecutive patients who underwent laminoplasty for CSM with radiculopathy between January 2006 and December 2012 were screened for eligibility. This study included 66 patients, who were treated with a laminoplasty of two or more levels and followed up for more than 2 years after surgery.Outcome Measures
The Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) scores, JOA recovery rates, and visual analog scale (VAS) were used to evaluate clinical outcomes. The C2–C7 sagittal vertical axis distance, cervical lordosis, range of motion (ROM), and angulation and vertebral slippage at the foraminotomy level were used to measure radiological outcomes using the whole spine anterioposterior or lateral and dynamic lateral radiographs.Methods
Sixty-six patients with CSM with radiculopathy involving two or more levels were consecutively treated with laminoplasty and followed up for more than 2 years after surgery. The first 26 patients underwent laminoplasty alone (LA group), whereas the next 40 patients underwent an additional posterior foraminotomy at stenotic neural foramens with radiating symptoms in addition to laminoplasty (LF group). In the LF group, the foraminotomy with less resection than 50% of facet joint to avoid segmental kyphosis and instability was performed at 78 segments (unilateral-to-bilateral ratio=57:21) and 99 sites. Clinical and radiographic data were assessed preoperatively and at 2-year follow-up and compared between the groups.Results
The NDI, JOA scores, JOA recovery rates, and VAS for neck and arm pain were improved significantly in both groups after surgery. The improvement in the VAS for arm pain was significantly greater in the LF group (from 5.55±2.52 to 1.85±2.39) than the LA group (from 5.48±2.42 to 3.40±2.68) (p<.001). Although cervical lordosis and ROM decreased postoperatively in both groups, there were no significant differences in the degree of reduction between the LF and LA groups. Although the postoperative focal angulation and slippage were slightly increased in the LF group, this was not to a significant degree. Furthermore, segmental kyphosis and instability were not observed in the LF group, regardless of whether the patient underwent a unilateral or bilateral foraminotomy.Conclusions
Additional posterior foraminotomy with laminoplasty is likely to improve arm pain more significantly than laminoplasty alone by decompressing nerve roots. Also, performing posterior foraminotomy via multiple levels or bilaterally did not significantly affect segmental malalignment and instability. Therefore, when a laminoplasty is performed for CSM with radiculopathy, an additional posterior foraminotomy could be an efficient and safe treatment that improves both myelopathy symptoms and radicular arm pain. 相似文献10.
Iencean SM 《The Journal of bone and joint surgery. British volume》2007,89(5):639-641
We present a novel method of performing an 'open-door' cervical laminoplasty. The complete laminotomy is sited on alternate sides at successive levels, thereby allowing the posterior arch to be elevated to alternate sides. Foraminotomies can be carried out on either side to relieve root compression. The midline structures are preserved. We undertook this procedure in 23 elderly patients with a spondylotic myelopathy. Each was assessed clinically and radiologically before and after their operation. Follow-up was for a minimum of three years (mean 4.5 years; 3 to 7). Using the modified Japanese Orthopaedic Association scoring system, the mean pre-operative score was 8.1 (6 to 10), which improved post-operatively to a mean of 12.7 (11 to 14). The mean percentage improvement was 61% (50% to 85.7%) after three years. The canal/vertebral body ratio improved from a mean of 0.65 (0.33 to 0.73) pre-operatively to 0.94 (0.5 to 1.07) postoperatively. Alternating cervical laminoplasty can be performed safely in elderly patients with minimal morbidity and good results. 相似文献
11.
《中国矫形外科杂志》2020,(3):204-208
[目的]探讨颈后路微型钛板法与锚钉法单开门椎管扩大成形术的临床疗效。[方法]回顾性研究2015年2月~2018年2月本院采用C_(3~7)颈后路单开门椎管扩大成形术治疗的78例多节段脊髓型颈椎病患者。术中36例采用微钛板,42例采用锚钉固定成形的椎板。[结果]所有患者均顺利完成手术,未发生神经血管损伤、脑脊液漏等术中并发症。两组患者在手术时间、术中出血量和术后引流量的差异均无统计学意义(P>0.05)。所有患者均随访12个月以上。术后12个月两组患者VAS和NDI评分均较术前显著减少,而JOA评分显著增加(P<0.05)。术前两组上述评分差异无统计学意义(P>0.05);术后12个月两组间VAS和JOA评分差异无统计学意义(P>0.05),但是,术后12个月钛板组的NDI评分显著低于锚钉组(P<0.05)。影像评估方面:两组患者术后3 d、术后12个月椎管前后径均较术前相比较显著增加(P<0.05)。随术后时间延长,钛板组椎管前后径、椎管扩大率和开门角度均无变化(P>0.05),而锚钉组椎管前后径、椎管扩大率和开门角度均显著丢失变小(P<0.05)。钛板组椎管再狭窄率为0 (0/36×5),而锚钉组椎管再狭窄率为5.24%(11/42×5)。[结论]微型钛板与锚钉颈后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病均能取得较好的临床疗效,但钛板维持椎管扩大的效果优于锚钉。 相似文献
12.
广泛椎板切除侧块钢板治疗多节段脊髓型颈椎病 总被引:1,自引:1,他引:0
目的探讨后路广泛椎板切除、侧块钢板内固定术治疗多节段脊髓型颈椎病的效果。方法39例多节段脊髓型颈椎病患者采用后路广泛椎板切除、侧块钢板内固定术。结果随访6-54个月,术前JOA评分为(9.5±1.75)分、术后为(12.98±2.96)分,差异有显著性(P〈0.001)。疗效评定采用JOA标准评定:优19例,良9例,一般7例,差4例。术后改善率30.4%-85.7%,平均69.2%±7.8%。结论颈后路广泛椎板切除、侧块钢板固定术是治疗多节段脊髓型颈椎病较理想的治疗方法。 相似文献
13.
目的 探讨后路选择性扩大减压、侧块螺钉内固定治疗伴有曲度后凸的多节段颈椎病的疗效及并发症预防。方法 2008年1月至2011年1月,采用颈椎后路手术治疗的患者43例,年龄42~74岁,平均59.6岁。手术前后采用日本骨科协会评分(Japanese Orthopaedic Association Scores,JOA)判定神经功能,颈椎功能残障指数量表(neck disability index,NDI)评价颈肩轴性痛程度,Ishihara法测定颈椎曲率指数(cervical curvature index, CI),在MRI上测量脊髓扩大和后移程度。结果 43例患者手术平均减压(3.91±0.86)个节段(3~5个节段)。全部病例平均随访38个月(20~60个月)。术后3~6个月复查时颈椎植骨完全融合。术后JOA评分为(14.31±1.33)分,较术前(8.16±1.11)分有明显改善,临床效果优良率为95.34%。术后CI为15.30%±3.18%,较术前7.36%±9.69%有明显改善。术后颈椎中立位MRI显示最狭窄处硬膜囊前后径为(6.10±0.89) mm较术前(2.92±1.49) mm明显增加,较术前增加了108.9%。颈脊髓平均向后漂移(4.59±1.20) mm(2.97~6.68 mm)。术后NDI评分为(4.90±2.46)分,较术前(19.36±8.61)分有明显改善。随访期间均未出现C5神经根麻痹,无内固定松动、脱出、断裂等并发症发生。结论 后路选择性扩大减压、侧块螺钉内固定术治疗伴有曲度后凸的多节段颈椎病,能有效地改善神经功能,恢复和维持颈椎正常曲度,降低轴性症状和C5神经根麻痹发生率。 相似文献
14.
目的探讨单开门颈椎管扩大成形单侧侧块内固定联合植骨术治疗颈椎伤病的可行性和疗效。方法利用单开门颈椎管扩大成形单侧侧块内固定联合植骨术治疗颈椎伤病患者16例,手术减压节段包括C3~53个节段2例,C3~64个节段5例,C3~75个节段9例。手术方式均采用单开门颈椎管扩大成形,门轴侧行侧块螺钉钢板内固定,并大量植骨。结果术中及术后均未发生脊髓、神经根及血管副损伤。全部患者平均随访18个月,术后3个月时JOA评分从术前的7.9分提高到13.1分。随访期间未见内固定物移位断裂及椎板再关门现象,门轴侧骨折处骨质融合。结论单开门颈椎管扩大成形单侧侧块内固定联合植骨术治疗颈椎伤病疗效安全可靠,经济实用,在椎管扩大成形获得即刻稳定的同时,提高植骨融合率,减少后凸畸形及失稳的发生率,减少椎板再关门现象。 相似文献
15.
颈后路减压钉棒内固定治疗伴后凸畸形的多节段脊髓型颈椎病 总被引:1,自引:1,他引:0
目的:探讨后路椎管后壁切除减压、钉棒系统内固定治疗伴后凸畸形的多节段脊髓型颈椎病的疗效。方法:2004年3月~2006年1月对15例伴后凸畸形的多节段脊髓型颈椎病患者行后路椎管后壁(全椎板及平双侧椎弓根内壁以内的侧块)切除减压、小关节植骨融合、钉棒系统内固定术(椎弓根螺钉6例,侧块螺钉9例)。根据术前、术后10d、术后6个月颈椎标准侧位X线片测量后凸Cobb角,以JOA评分评估神经功能改善情况。结果:随访6~24个月,平均10个月,均获骨性融合。术后6个月时JOA评分与术前比较有显著性差异(P<0.05),平均改善率为65.1%。术后10d后凸Cobb角与术前相比有显著性差异(P<0.05),术后6个月时后凸Cobb角与术后10d比较无统计学差异(P>0.05)。结论:后路椎管后壁切除减压、钉棒内固定术是治疗伴后凸畸形的多节段脊髓型颈椎病的可行、有效的方法。 相似文献
16.
《中国矫形外科杂志》2017,(13):1183-1186
[目的]观察多节段脊髓型颈椎病颈后路单开门椎管扩大成形微型钛板固定术的治疗效果。[方法]选自2012年1月~2014年6月本院收治的多节段脊髓型颈椎病患者42例,观察患者术前术后JOA评分、神经功能改善率、椎管扩大、颈部轴性症状及C5神经根麻痹发生情况。采用t检验,定义P<0.05时差异具有统计学意义。[结果]所有患者均获得随访6~18个月,平均11.5个月。术前平均JOA评分(8.60±1.90)分,随访时平均JOA评分(13.12±1.88)分(P=0.001),神经功能改善率为28.57%~77.78%,1例出现轴性症状,颈部轴性症状发生率2.4%,C5神经根麻痹0例,术后测量X线片或CT、MRI椎管矢状径扩大7.1~10.9 mm,平均(9.48±0.83)mm。[结论]:多节段脊髓型颈椎病颈后路单开门椎管扩大成形微型钛板固定术治疗效果肯定,操作简单,减压效果好。 相似文献
17.
目的探讨颈后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病的疗效及影响因素。方法对76例多节段脊髓型颈椎病患者行后路单开门椎管扩大成形术,术前术后进行JOA评分及Hirabayashi改善率评分。结果 76例均获随访,时间6~36(24.6±10.2)个月。JOA评分:术前为9.5分±2.41分,术后为12.92分±1.69分(P<0.05)。术后患者神经功能有不同程度的改善,末次随访改善率为54.60%±15.52%。结论颈后路单开门椎管扩大成形术能有效地解除脊髓的压迫,改善神经功能,疗效肯定。年龄、病程、术前JOA评分对脊髓功能改善率影响显著,年龄越大、病程越长、术前JOA评分越低的患者,术后脊髓功能改善越差。 相似文献
18.
目的 探讨颈椎后路单开门椎管扩大椎板成形术治疗多节段脊髓型颈椎病(MCSM)合并颈源性头痛的临床疗效。方法 2018年1月—2021年6月,采用颈椎后路单开门椎管扩大椎板成形术治疗MCSM合并颈源性头痛患者31例,术前及术后1、3、12个月采用日本骨科学会(JOA)评分评价临床疗效,采用颈椎功能障碍指数(NDI)“头痛问题”Q5评分评价头痛程度。结果 所有手术顺利完成,所有患者随访>12个月。患者术后各随访时间点JOA评分较术前显著改善,差异均有统计学意义(P<0.05)。除1例轻度头痛患者术后头痛无缓解,其余患者头痛均不同程度缓解。结论 颈椎后路单开门椎管扩大椎板成形术能缓解MCSM合并颈源性头痛患者的临床症状。 相似文献
19.
20.
改良颈椎后路单开门椎管扩大成形术治疗多节段脊髓型颈椎病 总被引:1,自引:0,他引:1
目的:总结保留颈半棘肌肌止、C3椎板切除、C4~C7“锚定”单开门椎管扩大成形术治疗多节段脊髓型颈椎病的临床效果.方法:2009年1月~2011年10月,共对74例多节段脊髓型颈椎病患者采用保留颈半棘肌肌止、C3椎板切除、“锚定法”固定悬吊C4~C7椎板的单开门椎管扩大成形术治疗,其中57例患者获得随访,男31例,女26例,年龄50~71岁,平均63岁.术前JOA评分4~11分,平均8.5±2.0分,颈椎活动度23°~49°,平均37.4°±10.3°,颈椎曲度指数6.0%~22.0%,平均(13.9±7.4)%.观察患者术中和术后并发症发生情况;术后6个月复查颈椎X线片,测量颈椎曲度指数和颈椎活动度,观察颈椎曲度指数和颈椎活动度变化情况;末次随访时对患者神经功能进行JOA评分,计算神经功能改善率 结果:手术均顺利完成,手术时间50~110min,平均70min.术中出血150~600ml,平均230ml.术中无脊髓损伤、脑脊液漏等并发症发生.术后早期41例患者有颈痛,给予消炎镇痛治疗,术后3周内疼痛消失或明显缓解2例出现切口感染,经抗感染治疗并再次清创后切口延时愈合.9例有明显轴性症状,发生率为15.8%;6例出现C5神经根麻痹,给予甲基强的松龙、营养神经药物等治疗后症状明显缓解.随访6~32个月,平均13个月,术后6个月颈椎曲度指数为4.2%~21.1%,平均(11.3±8.1)%,较术前丢失(2.9±2.4)%;颈椎活动度为18°~46°,平均28.2°±10.8°,平均丢失8.2°±5.1°.患者神经功能均不同程度得到改善,末次随访时JOA评分为10~17分,平均13.8±2.3分,较术前明显提高(P<0.05),神经功能改善率为29.0%~77.3%,平均(57.0±19.7)%.末次随访均未发现“再关门”现象.结论:保留颈半棘肌肌止、C3椎板切除、“锚定法”固定悬吊C4~C7椎板的单开门椎管扩大成形术可明显改善多节段脊髓型颈椎病患者的神经功能,手术操作简单,临床疗效满意. 相似文献