颈后路单开门椎弓根钉固定治疗颈椎管狭窄并颈椎失稳症

目的]探讨一次完成颈后路单开门并椎弓根钉固定治疗颈椎管狭窄并颈椎失稳的可行性及治疗效果。方法]本组选取颈椎管狭窄并颈椎失稳患者15例，术前X线片测量均有发育性椎管狭窄并椎体间不稳，磁共振显示脊髓受压明显；手术采用颈后路C3-7单开门减压椎管成形术，不稳节段用自行研制的全脊柱椎弓根固定系统内固定并突间关节间植骨融合术。结果]术中未出现并发症，术后神经症状明显改善，拍片检查提示置钉位置正确，随诊7．18个月，平均13个月，短期内复诊，椎弓根固定系统牢靠，无松动。结论]一次完成颈后路单开门并椎弓根钉固定治疗颈椎管狭窄并颈椎失稳是一种简捷、可靠的治疗方法，避免了前后路联合手术，近期内疗效满意。

Posterior single open-door and pedicle screw in the treatment of canal stenosis and instability of cervical vertebrae

Objective]To explore the feasibility and outcome of posterior single open-door and pedicle screw in treating canal stenosis and instability of cervical vertebrae at one time.Method]The preoperative radiographs of 15 patients were measured and were diagnosed to be developmental spinal canal stenosis and instability of cervical vertebrae.MRI showed the spinal cords were compressed obviously.Posterior C_(3~7) single open-door decompression and canal-plasty was adopted.Self-designed pedicle screws and intertransverse fusion were used in the unstable segments.Result]Complications were not found after the operation.The postoperative radiographs showed that the screws were in the right places.The average follow-up time was 13 months,ranging from 7 to 18 months.The short-term radiographs showed firmly fixed screws.Conclusion]It is a simple and reliable method to treat canal stenosis and instability of cervical vertebrae at one time with posterior single open-door and pedicle screw.Anterior and posterior operations have been avoided and the short-term outcome is satisfied.