颈椎后路椎管扩大成形术治疗颈椎管狭窄症92例疗效观察

目的:探讨颈椎后路(单/双开门)椎管扩大成形术治疗颈椎管狭窄症的临床疗效。方法:对我院在1998年11月～2004年11月,采用颈椎后路单、双开门椎管扩大成形术治疗的92例颈椎管狭窄症患者进行随访,分析术前、术后症状、体征的改善情况。结果:随访0.5～6.5年,多数病人脊髓功能均有不同程度的恢复。按JOA评分标准,单开门组改善率为61.6%,优良率为88.6%;双开门组改善率为63.9%,优良率为91.2%。本组平均改善率为63.0%,优良率为90.2%。结论:颈椎后路椎管扩大成形术用于治疗颈椎管狭窄症,疗效满意,是颈椎管狭窄症有效的治疗方法。单、双开门后路椎管扩大成形术对术后脊髓功能恢复的影响无显著性差异(P>0.05)。

Effect observation of 92 patients with cervical spinal stenosis treated with expansive laminoplasty

Objective To investigate the clinical efficacy of (unilateral/bilateral) expansive laminoplasty in the treatment of cervical spinal stenosis. Method 92 patients with cervical spinal stenosis underwent unilateral or bilateral expansive laminoplasty in our hospital from November 1998 to November 2004 were followed up. The spinal function recovery or improvement rates were analyzed by Japanese Orthopedic Association(JOA) score system. Results The follow-up period ranged from 0.5 to 6.5 years, with an average of 2 years and recovery or improvement of spinal function was found in the most patients. The results were evaluated with JOA score system, the average improvement rate of unilateral and bilateral expansive open-door laminoplasty was 61.6% and 63.9% respectively, and the excellent rate achieved in 88.6% and 91.2% respectively. The total average improvement rate was 63.0% and the total excellent rate was 90.2%. Conclusion Expansive laminoplasty is an effective method in the treatment of cervical spinal stenosis. Both unilateral and bilateral expansive open-door laminoplasty have their own strongpoints and shortcomings, and no difference in spinal function improvement was found (P>0.05).