颈椎后路椎管扩大成形加短节段固定手术疗效及影响因素分析

目的探讨颈椎后路椎管扩大成形加短节段固定手术治疗脊髓型颈椎病的疗效及影响因素。方法 2006-08-2008-06因脊髓型颈椎病行颈椎后路单开门椎管扩大成形加颈椎侧块钉棒系统固定融合术的患者21例,将患者的年龄、病程、术前椎管矢状径值、骨性椎管扩大率、脊髓后移距离、术前JOA评分诸影响因素与JOA改善率进行多元逐步回归分析,分析JOA改善率与上述诸因素的相关性。结果术前JOA评分、病程与JOA改善率明确相关,有显著性统计学意义。病程与JOA改善率呈明显负相关,术前JOA评分与JOA改善率呈明显正相关。结论颈椎后路单开门椎管扩大成形加颈椎侧块钉棒系统固定融合术是治疗脊髓型颈椎病的有效方法;术前JOA评分和病程是决定脊髓型颈椎病预后的重要因素,是判断预后的重要指标,两者相比,术前JOA评分更重要。

Multiple factors analysis on the outcomes of cervical spondylotic myelopathy with laminoplasty and interal fixafion

Objectives To analyze the outcomes and related factors of mono open door laminoplasty and posterior lateral mass fixation in cervical spondylotic myelopathy.Methods Totally 21 patients were reviewed.The patient’s age,course of disease,diameter of spinal canal before operation,amplification degree of diameter of spinal canal,shift of the spinal cord,JOA before operation and improvement rate of JOA after operation were recorded.Then we use SPSS to analyze the relationships among them.Results There was a positive correlation between JOA before operation and improvement rate of JOA after operation.And there was a negative correlation between course of disease and improvement rate of JOA after operation.Conclusion It is a good means for cervical spondylotic myelopathy to do the operation of mono open door laminoplasty and posterior lateral mass fixation.The course of disease and JOA before operation are good prognostic indicator to judge the operation result in cervical spondylotic myelopathy.