中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (3): 350-352.

• 临床研究 • 上一篇    下一篇

微型钛板与锚定法颈椎单开门治疗颈椎病效果的对比研究

温世锋1,2, 郭东明2, 徐中和2, 肖文德2, 李菊根3, 尹庆水4   

  1. 1. 南方医科大学研究生学院,  广州   510515; 2. 广州市第一人民医院脊柱外科,  广州   510180;
    3. 广州医学院第二附属医院骨科,  广州   510260;    4. 广州军区广州总医院骨科医院,  广州   510010
  • 收稿日期:2013-03-01 出版日期:2013-05-25 发布日期:2013-06-06
  • 通讯作者: 尹庆水,主任医师,教授,博士生导师,Tel:(020)36653539, Email:pjhkone@hotmail.com E-mail:93071@163.com
  • 作者简介:温世锋(1973-),江西省人, 硕士,副主任医师,主要从事脊髓型颈椎病的临床与基础研究, Tel:13825049160

Mini titanium plate fixation versus anchor fixation in unilateral open-door laminoplasty for treatment of multilevel cervical myelopathy

WEN Shi-feng 1,2, GUO Dong-ming2, XU Zhong-he2, XIAO Wen-de2, LI Ju-geng3, YIN Qing-shui4   

  1. 1. Southern Medical University, Guangzhou 510515, China; 2.Department of Spine Surgery, Guangzhou First People's Hospital, Guangzhou 510180, China;  3.Department of Orthopaedics, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China; 4.Department of Orthopadedics, Guangzhou General Hospital of PLA, Guangzhou 510010, China
  • Received:2013-03-01 Online:2013-05-25 Published:2013-06-06

摘要:

目的 比较颈椎单开门应用两种固定技术治疗多节段脊髓型颈椎病的的临床及影像学结果。  方法 55例多节段脊髓型颈椎病患者,均进行颈椎单开门椎管扩大成形术,根据内固定技术分为微型钛板固定技术(A组) 26例和锚定法固定技术(B组)29例。通过比较JOA评分及改善率评价临床疗效,而影像学结果则通过比较X线颈椎曲度变化值和MRI椎管与脊髓最狭窄处面积进行评估。  结果 其中50例获得随访6~42个月,平均(27.1±9.9)个月。两组患者随访时JOA评分及改善率比较差异均无统计学意义(P>0.05);而在颈椎曲度变化值、椎管与脊髓最狭窄处面积变化值等方面,A组均优于B 组(P<0.05)。  结论 两种颈椎单开门内固定技术治疗多节段脊髓型颈椎病均可获得良好的神经功能改善;但微型钛板固定技术获得更好的影像学结果。

关键词: 颈椎病, 椎板成形术, 单开门, 微型钛板, 锚定法

Abstract:

Objective To evaluate clinical efficacy of mini titanium plate fixation versus anchor fixation in unilateral open-door laminoplasty for treatment of multilevel cervical myelopathy (MCM). Methods A retrospective study of fifty-five patients with MCM who had undergone unilateral open-door laminoplasty was performed. Twenty-six patients underwent surgery with mini titanium plate fixation (A group)and twenty-nine patients with anchor fixation(B group) respectively. Clinical results were assessed by comparing the following parameters between patients who were in the two groups: Japanese Orthopaedic Association (JOA) score and JOA recovery rate, and image results were measured by Ishihara's curvature index, and area of the narrowest spinal canal and spinal cord in MRI. Results Fifty patients were followed up from 6 to forty-two months with an average of (27.1±9.9) months. No statistically significant differences were identified in follow-up JOA score and JOA recovery rate(P>0.05). A group had larger difference between the pre- and postoperative Ishihara's curvature index, area of the narrowest spinal canal and spinal cord(P<0.05). Conclusions Satisfactory recovery of neurological function can be achieved and maintained by the two fixations,however, A group had better image results than B group.

Key words: Cervical myelopathy, Laminoplasty, Unilateral open door, Mini titanium plate, Anchor fixation

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