颈椎单开门微型钢板内固定治疗颈椎管狭窄症

目的探讨颈椎单开门微型钢板内固定治疗颈椎管狭窄症的临床疗效。方法微型钢板应用于42例患者后路单开门椎管扩大椎板成形术中。25例为多节段颈椎间盘突出,5例为发育性颈椎管狭窄,12例为长节段后纵韧带骨化。对患者术前及术后2周的JOA评分及椎管矢状径进行评价。结果 JOA评分:术前为7.3分±2.8分,术后2周为13.4分±3.4分,平均提高6.1分±2.3分,缓解率为62%±25%。椎管矢状径:术前为9.5 mm±1.8 mm,术后为19.8 mm±2.6 mm。术后JOA评分、椎管矢状径与术前比较差异均有统计学意义﹙P0.01﹚。出院后1个月X线片均显示手术节段未发生关门现象,稳定性良好。结论微型钢板在颈椎管狭窄后路手术中可防止再关门、减少轴性疼痛、防止铰链侧椎板断裂后断端插入椎管的危险,患者能早期下地活动,近期疗效较好。

Clinical application of cervical open-door laminoplasty and mini-plate internal fixation in the treatment of cervical spinal canal stenosis

Objective To investigate the clinical curative effect of cervical open door and mini-plate internal fixation in the treatment of cervical spinal canal stenosis. Methods Mini plate was applied to 42 cases of posterior single open door laminoplasty. 25 cases of multilevel cervical disc herniation, 5 cases of developmental cervical spinal canal stenosis, 12 cases of long segment ossification of posterior longitudinal ligament were enrolled. Preoperation and 2 weeks postoperation,the Japanese Association for Departlnent of Orthopedics of cervical vertebra disease function score （JOA） and sagittal diameter of spinal canal score were recorded. Results The preoperative J0A score was 7.3 ±2.8, 2 weeks after operation, JOA score was 13.4±3.4, the average improvelnent was 6. 1 ± 2. 3, remission rate was 62%±25%. Sagittal dialneter of spinal canal before operation and 9.5 mm ± 1. 8 mm,19. 8 mm±2. 6 mm pre-operative and postoperative JOA score, sagittal diameter of spinal canal on the colnparison, the difference was statisti-tally significant （P〈0.01）. 1 month after discharged patients were taken X ray anteroposterior and lateral, results showed the operation section had not closed phenolnenon, good stability. Conclusions Mini plate in the cervical ca-nal to prevent reclosure, reduce the axial pain, prevent the hinge side lalnina fracture broken, and patients can do early ambulation.