摘要
目的探讨不同开门角度颈椎单开门微型钛板固定椎管成形术治疗多节段脊髓型颈椎病的临床疗效。方法行颈椎单开门微型钛板固定椎管成形术的多节段脊髓型颈椎病患者82例,根据术后3个月复查椎板开门角度分为<35°组和≥35°组各41例。比较2组术前及术后6个月日本骨科协会评估治疗(Japanese Orthopaedic Assocation,JOA)评分、颈椎曲度指数、颈椎轴性症状和C_5神经根麻痹发生情况。结果<35°组术前、术后6个月JOA评分[(8.54±1.53)、(13.81±2.57)分]和颈椎曲度指数[(14.22±2.78)%、(12.71±1.43)%]与≥35°组[(8.72±1.55)、(14.13±2.60)分;(14.06±2.59)%、(12.57±1.40)%]比较差异无统计学意义(P>0.05);2组术后6个月JOA评分明显高于术前,颈椎曲度指数低于术前(P<0.05);<35°组术后6个月颈椎轴性症状发生率(9.76%)低于≥35°组(26.83%)(P<0.05),C_5神经根麻痹发生率(4.88%)与≥35°组(7.32%)比较差异无统计学意义(P>0.05)。结论颈椎单开门微型钛板固定椎管成形术治疗多节段脊髓型颈椎病中不同椎板开门角度与临床疗效无明显关系,开门角度过大可增加患者颈椎轴性症状发生率。
Objective To investigate the influence of different open angle on the clinical effect of single open-door minititanium plate fixation laminectomy on multi-level cervical spondylotic myelopathy.Methods Eighty-two patients with multi-level cervical spondylotic myelopathy undergoing single open-door mini-titanium plate fixation laminectomy were divided into<35°group(n=41)and ≥35°group(n=41)according to the open angle measured 3 months after operation.The spinal cord function,cervical curvature index,cervical axial symptoms and C_5 nerve root paralysis were compared between two groups.Results There were no significant differences in JOA scores(8.54±1.53,13.81±2.57)and cervical curvature indexes((14.22±2.78)%,(12.71±1.43)%)in<35°group in comparison with those in ≥35°group(8.72±1.55,14.13±2.60;(14.06±2.59)%,(12.57±1.40)%)before and 6 months after operation(P>0.05).The JOA scores in two groups were significantly higher 6 months after operation than those before operation(P<0.05),and the cervical curvature indexes were significantly lower than those before operation(P<0.05).The incidence of cervical axial symptoms was significantly lower in <35°group(9.76%)than that in ≥35°group(26.83%)(P<0.05).There was no significant difference in the incidence of C_5 nerve root palsy between<35°group(4.88%)and≥35°group(7.32%)(P>0.05).Conclusion The open angle has no influence on the clinical result of mini-titanium plate fixation laminectomy for multi-level cervical spondylotic myelopathy.The excessive large open angle would increase the incidence of cervical axial symptoms.
引文
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