颈椎后路单开门加侧块内固定治疗椎管狭窄伴不稳

目的 探讨颈椎侧块钢板内固定加后路单开门术治疗颈椎管狭窄合并颈椎不稳定的疗效。方法对21例颈椎管狭窄脊髓损伤合并颈椎不稳定病人，采用Ⅰ期后路单开门减压加侧块钢板内固定，椎间小关节植骨融合术。查体按日本矫形学会joA分级法评定，拍颈椎片观察小关节融合情况。结果经过平均9个月随访，本组术前平均评分为9．5分，术后评分为16．2分，平均改善率86．6％。术后4月复查椎间小关节已融合。CT复查片示开门侧未见有再关门现象。结论侧块内固定加单开门术治疗颈椎管狭窄伴不稳是疗效确切、术式简便的治疗方法。

Clinical observation of treating cervical spinal canal stenosis and cervical instability with laternal mass internal fixation and posterior extended open- door laminoplasty

Objective To evaluate the clinical results of the treating cervical spinal canal stenasis and cervical instability with laternal mass internal fixation and posterior extended open - door laminoplasty. Methods 21 cases were treated for cervical spinal canal stenosis with cervical instability by lateral mass internal fixation posterior extended open - door laminoplasty and facet joint fusion, Results were evaluated according to the JOA score system. And postoperative plain X- Ray was done to evaluate the facet joint fusion. Results All eases were followed up with an average of 9 months. The average preoperative JOA score was 9.5, and the postoperative JOA score was 16.2. The average improvement rate was 86.6%. The facet joint was fused after 4 months postoperatively in radiogram. There was no case of door re - closure by postoperative CT. Conclusion Laternal mass internal fixation and posterior extended open - door laminoplasty is a simple and effective treatment of cervical spinal canal stenasis with cervical instability.