颈后路双开门椎管扩大成形术联合C2穹隆式减压治疗颈椎管狭窄症的疗效评价
摘要点击次数: 20   全文下载次数: 0   投稿时间:2019-04-02  修订日期:2019-06-18  
作者Author单位AddressE-Mail
孙宜保 Sun Yibao 郑州市骨科医院 郑州市骨科医院 yibaosun@163.com 
李毅力 LI Yili 郑州市骨科医院  
杨勇* Yang Yong 郑州市骨科医院 郑州市骨科医院 13603862327@163.com 
期刊信息:《中国骨伤》年,第卷,第期,第-页
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中文摘要:目的:探讨颈后路双开门椎管扩大成形术联合C2穹隆式减压治疗颈椎管狭窄症的临床疗效。方法:回顾性分析2016年6月至2018年6月行颈椎后路双开门椎管扩大成形术联合C2穹隆式减压治疗的28例患者的临床资料,男17例,女11例,年龄39~74(61.0±6.7)岁。根据患者术后临床疗效及术前、后影像学资料,从JOA评分、轴性症状、颈椎活动度、颈脊髓压迫程度等方面进行评价。结果:术后患者随访6~12月(平均10.2月),术后末次随访JOA评分均明显高于术前(P<0.05)。术前、后患者颈椎活动度分别为(41.8±15.3)°,(36.3±18.2)°,差异无统计学差异(P>0.05)。颈2-3椎管水平最狭窄部位矢状径术前、后分别为8.38±1.16mm,16.20±1.82mm,术后颈椎管矢状径明显扩大,与术前比较差异显著性(P<0.05 )。术后未出现轴性症状患者24例,有轴性症状患者4例,发生率14.29%。结论:颈后路双开门椎管扩大成形术联合C2穹隆式减压可以直接扩大颈2-3椎管容积,解除脊髓及神经根压迫,同时又尽可能地减少对颈椎后方韧带复合体的损伤,保持颈椎序列的稳定性,减少术后轴性症状,术式相对简单,无需使用金属内固定,疗效满意。
【关键词】双开门椎管扩大成形术  颈椎管狭窄症  穹隆式减压  后方韧带复合体
 
The evaluation of double-door laminoplasty combined with C2 dome decompression in treatment of cervical spinal stenosis
ABSTRACT  Objective:To investigate the clinical effect of double-door laminoplasty combined with C2 dome decompression in treatment of cervical spinal stenosis.Methods:Retrospective analysis was conducted in 28 cervical spinal stenosis patients with C2-C3 spinal stenosis undergoing double-door laminoplasty combined with C2 dome decompression from June 2016 to June 2018,including 17 males and 11 females. Age 39-74 years, average 61士6.7 years. According to the postoperative clinical efficacy, preoperative and postoperative imaging data, JOA score, axial symptoms, cervical spine activity, cervical spinal cord compression degree and other aspects were evaluated.Results:All patients were followed up for 6-12 months (mean 10.2 months).The JOA score in the last follow-up was significantly higher than that before surgery(P<0.05).The range of motion before and after surgery was respectively (41.8±15.3)°,(36.3±18.2)°,there was no significant difference (P > 0.05).After operation, sagittal diameter at the narrowest level of C2-3 spinal canal was 16.20±1.82mm,which was significantly higher than 8.38±1.16mm before operation(P<0.05).There were 24 patients without axial symptoms and 4 patients with axial symptoms,the incidence was 14.29%.Conclusion:Double-door laminoplasty combined with C2 dome decompression can directly expand C2-3 vertebral canal volume,relieve spinal cord and nerve root compression, minimize the damage of the posterior cervical ligament complex,maintain the stability of cervical spine sequence,reduce postoperative axial symptoms.The operation is relatively simple, without internal fixation, the?effect?of?satisfaction.
KEY WORDS  Double-door laminoplasty  cervical spinal stenosis  dome decompression  Posterior ligamentous complex
 
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