单开门椎管扩大成形结合微型钛板内固定术短期疗效分析

目的探讨单开门椎管扩大成形结合微型钛板内固定术的短期疗效。方法回顾性分析行单开门椎管扩大成形微型钛板内固定术的61例患者的手术时间、出血量、JOA评分、颈椎管矢状径、颈椎生理曲度的变化以及相关并发症情况，评估该术式的临床疗效。结果61例患者手术时间（149.02±41.34）min，术中出血（154.92±100.29）mL。JOA评分术前为（8.15±2.20）分，术后6月为（14.33±1.74）分，较术前明显提高(P<005)，脊髓功能改善率为68.41%。术前颈椎曲度（19.06±7.39）°，术后6月为（16.30±6.69）°，较术前有所下降（P<0.05）。各节段的椎管矢状径术前为（8.42±1.73）mm，术后为（16.21±2.92）mm，较术前显著性提高（P<0.05），颈椎管矢状径改善率92.6%。术后9例（14.75%）出现轴性症状。结论单开门椎管扩大成形微型钛板内固定术在神经功能恢复、术后椎管矢状径恢复均满意，操作简便，是一种安全有效、操作简单、疗效显著的新术式。

A Primary Study on Cervical Expansive Open-door Laminoplasty with Mini Titanium Plate

ObjectiveTo evaluate the short-term clinical effects of the mini titanium plate in cervical expansive open-door laminoplasty.MethodsThe clinical data of 61 patients with cervical stenosis that had been treated with cervical open-door laminoplasty with mini titanium plate fixation were retrospectively analyzed.The operation time, blood loss, Japanese Orthopaedic Association Scores (JOA score), the changes of sagittal diameter of cervical canal and cervical curve before and after surgery, and postoperative complications were evaluated to assess the effect of this surgery.ResultsThe average operation time was (149.02±41.34) min.The blood loss was (154.94±100.29)mL.The JOA score before surgery score was (8.15±2.20), while the JOA score after surgery increased to (14.33±1.74) which was significantly improved (P<0.05).The improve rate of JOA score was 68.41%.The cervical curve before surgery was (19.06±7.39)°, while the cervical curve decreased to (16.30±6.69)° 6 months after surgery, which had significantly statistically difference (P<0.05).The average sagittal cervical canal diameter before surgery was (8.42±1.73)mm, while the average sagittal cervical diameter after surgery was (16.21±2.92)mm.The improvement rate of sagittal cervical diameter was 92.6%.Five cases (16.12%) appeared axial symptoms.ConclusionOpen-door laminoplasty with mini titanium plate internal fixation can achieve satisfied clinical effects on the recovery of neural function and improvement rate of sagittal cervical canal diameter.The laminoplasty with mini plate fixation is proved to be a safe and effective operation.