颈椎后路术后颈椎曲度不良与疗效的相关性

目的：探讨颈椎后路手术治疗颈椎退变性疾病后颈椎曲度不良与疗效的相关性。方法：采用颈椎后路减压术治疗颈椎退变性疾病患者85例,其中全椎板减压术26例、单开门椎管扩大成形术39例和单开门棘突重建扩大成形术20例,观察手术后颈椎后凸畸形对治疗效果的影响。结果：经6-72个月,平均18个月随访,颈椎后凸与否,各组之间神经功能改善率差异无统计学意义（P〉0.05）;单开门椎管扩大成形术与单开门棘突重建椎管扩大成形术,术后颈椎后凸发生率低于全椎板减压术（P〈0.05）;颈椎无后凸与轻度后凸（与A、B、C的对应关系）畸形之间的轴性症状发生率无差异,但与明显后凸组相比有差异性（P〈0.05）。结论：颈椎后路减压术是治疗颈椎退变性疾病常用的手术方法,具有椎管容积扩大明显等优点。但减少手术对后方肌肉韧带复合体损伤并对此复合体进行有效修复,可以减少颈后凸畸形和轴性症状发生,提高手术效果。

Relationship between the Postoperative Unhealthy Curvature of Cervical Vertebrae and Therapeutic Effects

Objective: To study the correlation between the postoperative unhealthy curvature of cervical vertebrae and therapeutic effects after treating degenerative disease concerning cervical vertebrae by posterior approach.Methods: The decompression procedure by posterior approach was performed on 85 cases with degeneration of cervical vertebrae,including 26 cases of full-laminectomy decompression,39 cases of single open-door laminoplasty,20 cases of expanding single open-door laminoplasty and reconstruction of spinous process.To study effect of the postoperative trachelocyrtosis on therapeutic effects.Results: During follow-up period of mean 18 months(ranged from 6 to 72 months),there was not statistically significant relationship between the trachelocyrtosis and the improvement rate of nervous function(P>0.05).The incidence rates of trachelocyrtosis after single open-door laminoplasty and single open-door laminoplasty and reconstruction of spinous process were obviously lower than that after full-laminectomy decompression(P<0.05).The incidence rate of axiality symptoms was not statistically significant difference between normal curvature of cervical vertebrae and slight trachelocyrtosis,but was statistically different comparing to patients with obvious trachelocyrtosis(P<0.05).Conclusions: The posterior decompression procedure is a commonly used operation for treating degeneration of cervical vertebrae,with advantages of obviously expanding volume of vertebral canal,etc.Reducing the injuries of complex of muscles and ligaments and repairing the complex in time could decrease the incidence rate of trachelocyrtosis and axiality symptoms,and could improve operative effects.