自制椎板线锯应用于颈椎后路双开门椎管扩大成形术(附35例报告)

【目的】评价自制颈椎椎板线锯用于颈椎后路棘突纵切双开门椎管扩大成形术。【方法】1998年1月至2002年4月,共在35例行颈椎后路双开门椎管扩大成形术中应用颈椎椎板线锯。其中男性患者28例,女性患者7例,年龄35～68岁,平均55.6岁。30例颈椎病患者伴3节或3节以上压迫或合并颈椎管狭窄;5例颈椎管狭窄合并颈椎外伤。日本矫形外科协会(Japanese Orthopaedic Association,JOA)颈髓症评分:3～13,平均:8.28。【结果】手术用时80～150 min,平均145.6min。术中出血量100～400mL,平均188mL。开门减压成形:5个节段15例,4个节段15例,3个节段5例;棘突纵行锯开时间:36～48 s/个,平均41s/个。术中从未发生断锯和卡锯现象。随访时间6～58个月,平均22.4个月。术后JOA评分:11～17,平均15.5。【结论】颈椎椎板线锯用于颈椎后路棘突纵切双开门椎管扩大成形术是安全和快捷的。

The Application of Threadwire Saw Desiged by the Authors to Bilateral Open- door Cervical Laminoplasty: A Report of 35 Cases

Objective] To evaluate the efficacy of self-made cervical laminar threadwire saw in bilateral open-door cervical laminoplasty. Methods] From January, 1998 to April, 2002, thirty-five patients (28 males, 7 females )aged from 35 to 68 yr. ( average: 55. 56 yr. ) were treated with bilateral open-door cervical laminoplasty using the cervical laminar saw. 30 cases of them had spinal cord compression (three or more levels ) or cervical spinal canal stenosis. The others 5 cases had cervical associated spinal stenosis with cervical injury. The Japanese Orthopaedic Association (JOA) scores for cervical myelopathy were 3 to 13(average: 8. 28) . Results] The times of operation were 80 to 150 min (average: 145. 6 min). The blood loss in operation was 100 to 400 mL(average 188 mL). 15 cases underwent 5 levels of laminoplasties, 15 cases underwent 4 levels, and 5 cases underwent 3 levels. The times for spinal process splitting were 36-48 s/one (average: 41s). None of the thread-wire saws broke or got stuck during operation. The mean follow-up period was 22.4 months (range: 6-58 months). The postoperative JOA scores were 11 to 17(average: 15. 5). Conclusion] The cervical laminar threadwire saw used in bilateral open-door cervical laminoplasty is safe and efficient.