单开门椎管扩大成形术的临床应用和进展

单开门手术适应证广泛,疗效肯定,临床常用于脊髓型颈椎病、颈椎后纵韧带骨化症的治疗。手术方式多样,包括棘突与椎旁肌、关节囊丝线缝合,同种异体骨或自体骨植于椎板开门侧,微型钢板和螺钉系统固定开门椎板以及棘突椎板螺钉加侧块螺钉钉棒系统技术的应用等,但各有优缺点。再关门、继发椎管狭窄和颈椎后凸畸形伴不稳是单开门椎管扩大术的主要并发症。现对该术式的临床应用进行总结,以便有效地指导临床工作。

Clinical Application and Progress of Unilateral Open-door Expansile Cervical Laminoplasty

Unilateral open-door expansile cervical laminoplasty has widely surgical indications,and favorable curative effect as treatments for cervical spondylotic myelopathy and ossification of posterior longitudinal ligament.Operation methods is of a great variety including the suture stay within the spinous process and the paraspinal muscles or facet joint capsules,the use of allograft or autograft on the open-door side,the miniplate and anchoring screw technique,and the use of spinous process laminar screw with lateral mass screw nail bar system technique,and so on,each with respective advantages and disadvantages.The main complications including re-closure of the hinge,subsequent restenosis and preoperative cervical kyphosis with instability.Here is to summarize the clinical applications to guide the clinical practice effectively.