微型钛板与锚定法颈椎单开门治疗颈椎病效果的对比研究

目的　比较颈椎单开门应用两种固定技术治疗多节段脊髓型颈椎病的的临床及影像学结果。 方法　55例多节段脊髓型颈椎病患者，均进行颈椎单开门椎管扩大成形术，根据内固定技术分为微型钛板固定技术(A组) 26例和锚定法固定技术（B组）29例。通过比较JOA评分及改善率评价临床疗效，而影像学结果则通过比较X线颈椎曲度变化值和MRI椎管与脊髓最狭窄处面积进行评估。 结果　其中50例获得随访6～42个月，平均(27.1±9.9)个月。两组患者随访时JOA评分及改善率比较差异均无统计学意义（P>0.05）；而在颈椎曲度变化值、椎管与脊髓最狭窄处面积变化值等方面，A组均优于B 组（P<0.05）。 结论　两种颈椎单开门内固定技术治疗多节段脊髓型颈椎病均可获得良好的神经功能改善；但微型钛板固定技术获得更好的影像学结果。

Mini titanium plate fixation versus anchor fixation in unilateral open-door laminoplasty for treatment of multilevel cervical myelopathy

Objective　To evaluate clinical efficacy of mini titanium plate fixation versus anchor fixation in unilateral open-door laminoplasty for treatment of multilevel cervical myelopathy (MCM).　Methods　A retrospective study of fifty-five patients with MCM who had undergone unilateral open-door laminoplasty was performed. Twenty-six patients underwent surgery with mini titanium plate fixation （A group）and twenty-nine patients with anchor fixation(B group) respectively. Clinical results were assessed by comparing the following parameters between patients who were in the two groups: Japanese Orthopaedic Association (JOA) score and JOA recovery rate, and image results were measured by Ishihara's curvature index, and area of the narrowest spinal canal and spinal cord in MRI.　Results　Fifty patients were followed up from 6 to forty-two months with an average of (27.1±9.9) months. No statistically significant differences were identified in follow-up JOA score and JOA recovery rate（P>0.05）. A group had larger difference between the pre- and postoperative Ishihara's curvature index, area of the narrowest spinal canal and spinal cord（P<0.05）.　Conclusions　Satisfactory recovery of neurological function can be achieved and maintained by the two fixations，however, A group had better image results than B group.