颈椎后路减压纳米人工椎板重建颈椎管的疗效分析

目的评估应用纳米人工骨重建颈椎椎管的临床疗效。方法对23例行颈椎后路减压人工椎板椎管重建术的患者进行随访。统计手术时间及术中出血量;采用JOA（日本矫形外科学会）评分标准评定患者脊髓神经功能状态;观察轴性症状及颈5神经根麻痹的发生情况;颈椎X线片及CT了解椎管矢状径扩大情况及人工椎板融合情况。结果手术时间平均92 min,术中出血量平均316 ml。人工椎板植入未见排斥反应,术后12月人工骨骨性融合率为45.5%。手术前后颈椎椎管矢状径差异有显著性,椎管矢状径均超过14 mm。JOA评分由术前平均9.6分增加至术后1年时平均15.1分,改善率为74.3%。3例出现轴性症状,理疗治疗后好转;未出现颈5神经根麻痹并发症。结论在颈椎后路减压手术中应用纳米人工椎板重建颈椎管可以获得较好的近期疗效。

Efficacy of posterior cervical decompression laminectomy reconstruction cervical artificial nano-tubes

Objective To study the effect of nano-artifieial vertebral lamina on posterior decompression and reconstruction of cervical vertebral canal. Methods Retrospective reviews were done in 23 patients who underwent posterior decompression and reconstruction of cervical vertebral canal with nano-artificial vertebral lamina. Operative time and blood loss were recorded. All patients were evaluated by JOA scores,while the incidence of axial symptoms and C5 nerve root palsy were observed. X-ray photography and CT were used to measure the bone fusion and sagittal diameter of cervical vertebral canal. Results The average operation time was 92 min and the bood loss was 316 ml . The clinical symptoms and physical signs were improved in all the patients after operation.JOA scores increased from 9.6 to 15.1 on an average,the improvement rate of JOA scores was 74.3%. There was significant difference in sagittal diameter of each segment vertebral canal between preop- eration and postoperation, and after operation the mean of sagittal diameter of each segment was more than 14 ram. The union rate of artificial vertebral lamina was 45.5% in 1 year.Axial symptoms were observed in 3 cases and no C5 nerve root palsy was found. Conclusion Posterior decompression andreconstruction of cervical vertebral canal with nano-artificial vertebral lamina is safe and effective.