河北医科大学学报

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颈椎板有限切除联合椎弓根螺钉固定治疗脊髓型颈椎病的临床效果分析

  

  1. 河北省邯郸市中心医院骨5科,河北 邯郸 056001
  • 出版日期:2018-08-25 发布日期:2018-07-25
  • 作者简介:李志远(1983-),男,河北邯郸人,河北省邯郸市中心医院主治医师,医学硕士,从事脊柱退行性疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题(20150452)

Clinical analysis of limited laminectomy combined with pedicle screw fixation in the treatment of cervical spondylotic myelopathy#br#

  1. The Fifth Department of Orthopedics, Central Hospital of Handan City, Hebei Province, Handan 056001, China
  • Online:2018-08-25 Published:2018-07-25

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察颈后路椎板有限切除联合椎弓根螺钉固定治疗多节段脊髓型颈椎病的临床效果。
〖HTH〗方法〖HTSS〗〖KG*2〗多节段脊髓型颈椎病患者35例,均采用颈后路椎板有限减压联合椎弓根螺钉固定术治疗,术后观察患者神经功能恢复、颈椎曲度指数、轴性症状及C5神经根麻痹发生发生情况。
〖HTH〗结果〖HTSS〗〖KG*2〗手术时间(139.9±24.1) min,术中出血量(285.9±51.3) mL,椎板切除宽度(16.5±1.1) mm;C5水平脊髓漂移距离为(2.8±0.3) mm。术后3个月和末次随访时JOA评分明显高于术前(P<005),末次随访时神经功能改善率达到(65.8±13.6)%。末次随访时颈椎曲度指数高于术前(P<005)。术后4例患者出现轴性症状,发生率为11.4%。2例患者出现C5神经根麻痹,发生率为5.7%。
〖HTH〗结论〖HTSS〗〖KG*2〗颈后路椎板有限切除联合椎弓根螺钉固定可解除脊髓压迫并促进神经功能恢复,避免颈椎后凸畸形,降低轴性症状及C5神经根麻痹的发生率。

关键词: 颈椎病, 椎板切除术, 椎弓根钉

Abstract: [Abstract]〓Objective〖HTSS〗〓To investigate the clinical effects of limited laminectomy combined with pedicle screw fixation in the treatment of multilevel cervical spondylotic myelopathy(MCSM).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirtyfive cases of MCSM patients were accepted the procedure of limited laminectomy combined with pedicle screw fixation. The postoperative neurological recovery, cervical curvature index(CCI), axial symptoms and C5 nerve root paralysis were recorded and analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The operative time was(139.9±24.1) min with a blood loss of(285.9±51.3) mL. The width of laminectomy was(16.5±1.1) mm and the distance of spinal cord drift at C5 level was(2.8±0.3) mm. At 3 months and the last followup, the JOA score was significantly higher than that of preoperation(P<005), and the neurological recovery rate at the final followup was(65.8±13.6)%. The CCI at the final followup was higher than preoperation(P<005). There were 4 cases of axial symptoms(11.4%) and 2 cases C5 nerve root paralysis(5.7%) occurred.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Limited laminectomy combined with pedicle screw fixation not only can relieve spinal cord compression and promote neurologcial recovery, but also avoid the occurrence of cervical kyphosis and decrease the axial symptoms. Most of all, it can reduce the incidence of C5 nerve root paralysis.

Key words: cervical spondylosis, laminectomy; pedicle screw