颈椎侧块钢板在脊髓型颈椎病治疗中应用

目的 对15例脊髓型颈椎病患者行后入路椎管减压、椎板成型术的同时使用颈椎侧块钢板固定，探讨和分析该手术方法的优点和手术治疗效果。方法 从自2000年3月—2002年12月，对15例脊髓型颈椎病患者(术前颈椎MR显示有三个节段颈椎椎间盘水平病变并有黄韧带增厚突入椎管)，行颈椎后入路双开门椎板成型术加双侧颈椎侧块钢板固定。按JOA评分法评定患者手术前后恢复情况。结果 本组患者男10例，女5例，随访5个月—1年2个月，平均9个月，术后2—7天(平均3．5天)可戴颈围坐起，颈围外固定时间12周，融合时间3—5个月，(平均为3．5个月)，术后JOA评分明显提高，所有病人无术中血管、神经根损伤，无植骨不愈合，无内固定断裂。结论 行颈椎后入路双开门椎板成型术联合应用颈椎侧块钢板固定，从后方扩大椎管容积，对脊髓进行减压，辅助以侧块钢板对减压后的颈椎行即时的稳定的固定，增加后方所植髂骨的融合成功率，大大地减少颈椎术后后突畸形发生和术后卧床并发症的发生率。

The treatment of cervical spondylotic myelopathy with the cervical lateral mass plate

Objective To investigate the adevantage and efficacy of treatment method that the cervical laminoplasty with cervical lateral mass plate and screw treated the cervical spondylotic myelopathy.Methods Fifteen cervical spondylotic myelopathy patient with three or four segments compression by degenerative disc and ligamentum flavum in preoperative MR were treated by cervical laminoplasty with lateral mass plate and screw.Japanese Orthopedic Association (JOA) score were used to measure the recovery of cervical spinal cord.Results This group has ten male and five female,the follow-up ranged from 3 months to 1 year and 2 months . Patients were encourged to sit up and wear soft collar 3.5 days (3-7 days) after the surgery.All the case had solid fusion at an average of 3.5 months.Neither of these patients have neurovascular complication during the operation.There was no lossening of the plate and screw.Conclusion The cervical laminoplasty can enlarge the spinal volume and decompress the spinal cord.Using the cervical lateral mass plate can provide immediate stability,increase the percentage of fusion and decrease the kyphotic deformity and bed ridden complication after operation.