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, 郭东明, 徐中和, 肖文德, 李菊根, 尹庆水
中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (3) : 350-352.
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
Mini titanium plate fixation versus anchor fixation in unilateral open-door laminoplasty for treatment of multilevel cervical myelopathy
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。
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.
颈椎病 / 椎板成形术 / 单开门 / 微型钛板 / 锚定法
Cervical myelopathy / Laminoplasty / Unilateral open door / Mini titanium plate / Anchor fixation
[1] 周峰, 杨惠林,王根林, 等. 颈椎单开门微型钛板固定与缝线悬吊固定治疗颈椎病
[J]. 中国矫形外科杂志, 2011,19(21):1761-1764.
[2]曾云, 熊敏, 余化龙, 等. 微型钢板与锚定法在单开门颈椎管扩大成形术中应用的对比研究
[J]. 中国修复重建外科杂志, 2011, 25(08):946-950.
[3] Rhee JM, Register B, Hamasaki T,,et al. Plate only open door laminoplasty maintains stable spinal canal expansion with high rates of hinge union and no plate failures
[J]. Spine, 2010, 36(1):9-14.
[4] Matsumoto M, Watanabe K, Tsuji T, et al. Risk factors for closure of lamina after open-door laminoplasty
[J]. J Neurosurg Spine, 2008, 9(6):530–537.
[5] Luk KD, Kamath V, Avadhani A, et al. Cervical laminoplasty
[J]. Eur Spine J, 2010, 19(2):347-348.
[6] 张学利,王善金,王云力, 等. 锚定法单开门椎管成形术对术后轴性症状和颈椎曲度影响的病例对照研究
[J]. 中国骨伤, 2008,10(21):759-762.
[7] Liu G,Buchowski JM,Bunmaprasert T,et al. Revision surgery following cervical laminoplasty: etiology and treatment strategies
[J]. Spine, 2009, 34(25):2760-2768.
[8] 张顺聪, 江晓兵, 唐永超, 等. CenterpieceTM微型钢板在颈椎单开门椎管成形术中的应用-附14例报告
[J]. 中国临床解剖学杂志,2012,30(03)356-358.
[9] Uematsu Y,Tokuhashi Y,Matsuzaki H. Radiculopathy after laminoplasty of the cervical spine
[J]. Spine,1998,23(19):2057-2062.
[10] Wang XY, Dai LY, Xu HZ, et al. Prediction of spinal canal expansion following cervical laminoplasty:a computer simulated comparison between single and double door techniques
[J]. Spine, 2006, 31(24):2863 -2870.
/
〈 |
|
〉 |