| ARCH钛板联合单开门椎管扩大成形术治疗脊髓型颈椎病的近期疗效观察 |
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投稿时间：2018-09-07
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| 期刊信息：《中国骨伤》2019年，第32卷，第3期，第278-282页 |
| DOI：10.3969/j.issn.1003-0034.2019.03.016 |
| 基金项目: |
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中文摘要:
目的：探讨ARCH钛板联合单开门椎管扩大成形术（expansive single open-door laminoplasty，EOLP）治疗脊髓型颈椎病（cervical spondylotic myelopathy，CSM）的近期临床疗效。
方法：2016年1月至2016年12月将ARCH钛板做内固定材料的EOLP应用于32例CSM患者的治疗中，男23例，女9例；年龄39~82岁，平均64.5岁；病程6~24个月，平均13.1个月。临床疗效评定采用日本骨科协会（JOA）评分法，评分内容包括上下肢运动功能、肢体感觉功能、膀胱功能。通过影像学资料测量术前和术后6个月最狭窄节段的椎管矢状径，计算其改善率以明确减压效果。
结果：所有患者获得随访，时间6~20个月，平均12.2个月。32例患者的术前症状均有不同程度好转，JOA评分由术前的9.78±1.34提高至术后6个月的12.94±1.16，JOA改善率为（44.09±11.06）%（P<0.01）。椎管扩大明显，最狭窄处椎管矢状径由术前的（8.47±0.60）mm扩大至术后6个月的（12.51±0.78）mm，改善率为（48.27±11.81）%（P<0.01）。随访期间未见内固定物松动、移位、断裂及"再关门"现象。
结论：ARCH钛板联合EOLP治疗CSM可明显减少出现"再关门"及其他相关术后并发症的可能，近期临床疗效满意。 |
| 【关键词】脊髓型颈椎病 单开门椎管扩大成形术 ARCH钛板 |
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| Short-term curative effects of ARCH titanium plate fixation combined with expansive single open-door laminoplasty in treating cervical spondylotic myelopathy |
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ABSTRACT
Objective:To evaluate the short-term curative effects of ARCH titanium plate fixation combined with expansive single open-door laminoplasty (EOLP) in treating cervical spondylotic myelopathy (CSM).
MethodsEOLP with ARCH titanium plate as internal fixation material was applied in 32 patients with CSM from January to December 2016. There were 23 males and 9 females with an average age of 64.5 years ranging from 39 to 82 years. The course of disease ranged from 6 to 24 months with an average of 13.1 months. The clinical efficacy was evaluated by Japanese Orthopaedic Association (JOA) scoring method,which included upper and lower limb motor function,limb sensory function and bladder function. The sagittal diameter of the narrowest segment of vertebral canal was measured by imaging data before operation and 6 months after operation,and the improvement rate was calculated to determine the decompression effect.
ResultsAll the patients were followed up from 6 to 20 months with an average of 12.2 months. Preoperative symptoms of 32 patients were improved to varying degrees,the JOA score increased from 9.78±1.34 before operation to 12.94±1.16 at 6 months after operation,the improvement rate of JOA was(44.09±11.06)% (P<0.01). The spinal canal was significantly enlarged,the sagittal diameter of the narrowest vertebral canal was increased from (8.47±0.60) mm preoperatively to (12.51±0.78) mm 6 months postoperatively,the improvement rate was (48.27±11.81)% (P<0.01). No loosening,displacement,rupture or "re-closure" of the internal fixator was found during the follow-up.
ConclusionARCH titanium plate fixation combined with EOLP in the treatment of CSM can significantly reduce the possibility of "re-closure" and other related postoperative complications and the short-term clinical efficacy is satisfactory. |
| KEY WORDS Cervical spondylotic myelopathy Expansive single open-door laminoplasty ARCH titanium plate |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘晓,赵增功,杨士翔,李志伟.ARCH钛板联合单开门椎管扩大成形术治疗脊髓型颈椎病的近期疗效观察[J].中国骨伤,2019,32(3):278~282 |
| 英文格式: | LIU Xiao,ZHAO Zeng-gong,YANG Shi-xiang,LI Zhi-wei.Short-term curative effects of ARCH titanium plate fixation combined with expansive single open-door laminoplasty in treating cervical spondylotic myelopathy[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(3):278~282 |
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