CenterpieceTM微型钢板在颈椎单开门椎管扩大成形术中的应用—附14例报告
张顺聪, 江晓兵, 唐永超, 梁德, 杨志东, 晋大祥, 姚珍松
中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (3) : 356-358.
CenterpieceTM微型钢板在颈椎单开门椎管扩大成形术中的应用—附14例报告
Clinical application of expansive open-door laminoplasty using CenterpieceTM titanium miniplate: an analysis of 14 cases
目的 评价应用CenterpieceTM微型钢板固定单开门椎管扩大成形术的疗效。 方法 采用改良单开门手术,C3、C5、C7椎板开门侧行CenterpieceTM微型钢板固定椎管扩大成形术治疗14例脊髓型颈椎病患者。 结果 随访6个月~2年,平均13.6个月。JOA评分由术前的(11.1±0.78)分提升为 (15.3±1.12)分(P<0.05),术后复查CT及MRI提示椎管显著扩大、脊髓减压,随访期间无一例发生内固定物松脱、门轴侧椎板内陷及再“关门”现象,术后2个月时仅有2例存在颈部轻微疼痛、僵硬感,术后半年复查症状消失。 结论 CenterpieceTM微型钢板固定单开门椎管扩大成形术治疗是治疗脊髓型颈椎病安全有效的术式,门轴固定牢固,能显著减少再关门现象及轴性症状。
Objective To evaluate the clinical outcome of expansive open-door laminoplasty using Centerpiece Titanium Miniplate internal fixation. Methods 14 cases with cervical spondylotic myelopathy(CSM) underwent expansive open-door laminoplasty, and CenterpieceTM plate internal fixation in C3, C5 and C7 segments. Neurological deficits pre- and post- operation were assessed using a scoring system proposed by Japanese Orthopaedic Association (JOA score). Results The period of follow-up lasted from 6 months to 2 years with a mean of 13.6 months. The JOA score were improved from 11.1 points pre-operation to 15.3 points at the latest follow-up(P<0.05). Reclosed open-door was not found. There were 2 cases had slight axial symptoms like neck pain and neck movement two months after the operation, and released when six months follow-up. Conclusions Expansive open-door laminoplasty is a reliable procedure for CSM. Centerpiece TM plate internal fixation may be an effective measure to prevent reclosed open-door and postoperative axial syndromes.
Cervical spondylotic myelopathy / Laminoplasty / Internal fixation
[1] Oyama M,Hattori S, Moriwaki N. A new method of posterior decompression
[in japanese]. Central Japan Journal of Orthopaedic Surgery and Traumatology,1973,16:792-794.
[2] 王少波,蔡钦林,党耕町,等.单开门颈椎椎管扩大成型术的远期疗效观察
[J].中华骨科杂志,1999,19(9):519-521.
[3] Bogduk N,Marsland A. The cervical zygapophyseal joints as a source of neck pain
[J]. Spine,1988,13(6):610-617.
[4] Dwyer A,Aprill C,Bogduk N. Cervical zygapophyseal joint pain Patterns 1:A study in normal volunteers
[J]. Spine,1990,15(4):453-457.
[5] Hosono N,Yonenobu K,Ono K. Neck and shoulder pain after laminoplasty: a noticeable complication
[J]. spine,1996,21(17):1969-1973.
[6] Pavlov H,Torg JS,Robie B,et a1. Cervical spinal stenosis: determination with vertebral body ratio method
[J]. Radiology, 1987,164(3):771-775.
[7] Hirabayashi K. Expensive open-door laminoplasty for cervical spondylotic myelopathy
[J]. Shujutsu,1978,32(10):1159-1163.
[8] Hirabayashi K,Watanabe K,Wakano K,etal. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy
[J]. Spine,1983,8(7):693-699.
[9] 孙 宇,张凤山,潘胜发,等. “锚定法”改良单开门椎管成形术及其临床应用
[J]. 中国脊柱脊髓杂志,2004,14(9):517-519.
[10]蔡钦林,王少波,李迈,等. 颈椎病手术并发症的防治
[J].中国脊柱脊髓杂志,1995,5(5):200-202.
[11]O'Brien M, Peterson D, Casey ATH, Crockard HA. A novel technique for laminoplasty augmentation of spinal canal area using titanium miniplate stabilization: a computerized morphometric analysis
[J]. Spine,1996,21(6):474-484.
[12]孙 宇,潘胜发,陈景春,等. 单开门颈椎管扩大椎板成形术对颈椎运动的影响
[J].中国脊柱脊髓杂志,2003,13(4):212-215.
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