全椎板减压侧块螺钉固定与单开门椎管成形治疗无骨折脱位型颈髓损伤的病例对照研究

目的:比较全椎板减压侧块螺钉固定与单开门椎管成形治疗无骨折脱位型颈髓损伤的临床疗效.方法:对2014年12月至2020年4月收治的75例无骨折脱位型颈髓损伤患者进行回顾性分析,其中男65例,女10例,年龄33～83(60.1±11.4)岁.按手术方式分为观察者(36例)与对照组(39例).观察组采用C3-C6单开门椎管...

A case-control study: the clinical efficacy of total laminectomy with lateral mass screw fixation and single open-door laminoplasty for cervical spinal cord injury without fracture and dislocation

Objective: To compare the clinical effects of total laminectomy with lateral mass screw fixation and single open-door laminoplasty in the treatment of cervical spinal cord injury without fracture and dislocation.Methods: The clinical data of 75 patients with cervical spinal cord injury without fracture and dislocation treated from December 2014 to April 2020 were retrospectively analyzed,including 65 males and 10 females,aged from 33 to 83 years old with an average of (60.1±11.4) years. According to surgical method,the patients were divided into observation group (36 cases) and control group (39 cases). The observation group was treated with C₃-C₆ single open-door laminoplasty. In the control group,the C₃-C₆ whole lamina was opened by "uncovering",and the lateral mass screw was fixed and fused. The general conditions including operation time,intraoperative blood loss,hospital stay and complications such as axial pain,cerebrospinal fluid leakage,postoperative C₅ nerve palsy were recorded. Visual analogue scale(VAS),Nurick pain scale,Japanese Orthopaedic Association(JOA) scores and American Spinal Injury Association(AISA) injury scale were used to evaluate the improvement of clinical symptoms and related functional recovery 12 months after operation.Results: There were no statistically significant differences in operation time,intraoperative blood loss and hospital stay between two groups(P>0.05). There were statistically significant differences in JOA,VAS,ASIA and Nurick scores of the all patients between 12 months after surgery and before surgery (P<0.05),and there was no significant difference between groups. There was significant difference in the incidence of C₅ nerve root palsy and axial pain between two groups(P<0.05),but there was no significant difference in the complications of cerebrospinal fluid leakage between two groups (P>0.05).Conclusion: Total laminectomy with lateral mass screw fixation and single open-door laminoplasty in treating cervical spinal cord injury without fracture and dislocation can obtain satisfactory results in restoring nerve function,alleviating pain and improving daily behavior,but single open-door laminoplasty has the advantages of less trauma and low incidence of complications.