| 颈后路双开门椎管扩大成形术联合C2穹隆式减压治疗颈椎管狭窄症 |
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投稿时间：2019-06-26
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| 作者 | Author | 单位 | Address | E-Mail |
| 孙宜保 |
SUN Yi-bao |
郑州市骨科医院微创脊柱科, 河南 郑州 450052 |
Department of Minimally Invasive Spine, Orthopaedics Hospital of Zhengzhou City, Zhengzhou 450052, Henan, China |
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| 李毅力 |
LI Yi-li |
郑州市骨科医院微创脊柱科, 河南 郑州 450052 |
Department of Minimally Invasive Spine, Orthopaedics Hospital of Zhengzhou City, Zhengzhou 450052, Henan, China |
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| 杨勇 |
YANG Yong |
郑州市骨科医院微创脊柱科, 河南 郑州 450052 |
Department of Minimally Invasive Spine, Orthopaedics Hospital of Zhengzhou City, Zhengzhou 450052, Henan, China |
13603862327@163.com |
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| 期刊信息：《中国骨伤》2020年，第33卷，第2期，第181-183页 |
| DOI：10.12200/j.issn.1003-0034.2020.02.018 |
| 基金项目: |
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中文摘要:
目的：探讨颈后路双开门椎管扩大成形术联合C2穹隆式减压治疗颈椎管狭窄症的临床疗效。
方法：回顾性分析2016年6月至2018年6月行颈椎后路双开门椎管扩大成形术联合C2穹隆式减压治疗的28例患者的临床资料，男17例，女11例，年龄39~74（61.0±6.7）岁。根据JOA评分、轴性症状、颈椎活动度、颈脊髓压迫程度等方面进行疗效评价。
结果：所有患者获得随访，时间6~12个月，平均10.2个月。术后末次随访JOA评分均明显改善（P<0.05）。手术前后患者颈椎活动度分别为（41.8±15.3）°，（36.3±18.2）°，差异无统计学差异（P>0.05）。C2-C3椎管水平最狭窄部位矢状径手术前后分别为（8.38±1.16）mm和（16.20±1.82）mm，术后颈椎管矢状径明显扩大（P<0.05）。4例术后出现轴性症状，发生率14.29%（4/24）。
结论：颈后路双开门椎管扩大成形术联合C2穹隆式减压可以直接扩大C2-C3椎管容积，解除脊髓及神经根压迫，同时又尽可能地减少了对颈椎后方韧带复合体的损伤，保持了颈椎序列的稳定性，减少了术后轴性症状的发生，且术式相对简单，无需使用金属内固定。 |
| 【关键词】双开门椎管扩大成形术 颈椎管狭窄症 穹隆式减压 后方韧带复合体 |
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| Double-door laminoplasty combined with C2 dome decompression for the treatment of cervical spinal stenosis |
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ABSTRACT
Objective: To investigate the clinical effect of double-door laminoplasty combined with C2 dome decompression in treatment of cervical spinal stenosis.
Methods: The clinical data of 28 patients with cervical spinal stenosis who underwent double-door laminoplasty combined with C2 dome decompression from June 2016 to June 2018 were retrospectively analyzed, including 17 males and 11 females,aged 39 to 74 years with an average of(61.0±6.7)years. The clinical effects were evaluated by JOA score,axial symptoms,cervical spine activity,cervical spinal cord compression degree and so on.
Results: All patients were followed up for 6 to 12 months with an average of 10.2 months. The JOA score in the final follow-up was significantly improved (P<0.05). The range of cervical activity before and after surgery was respectively (41.8±15.3)°,(36.3±18.2)°,and there was no significant difference (P>0.05). After operation,sagittal diameter at the narrowest level of C2-C3 spinal canal was (16.20±1.82) mm,which was significantly higher than (8.38±1.16) mm before operation(P<0.05). There were 4 cases with axial symptoms in 24 patients with the incidence rate of 14.29%(4/24).
Conclusion: Double-door laminoplasty combined with C2 dome decompression can directly expand the volume of C2-C3 spinal canal,relieve the compression of spinal cord and nerve root,reduce the damage to the posterior cervical ligament complex as much as possible,maintain the stability of cervical spine sequence,reduce the occurrence of axial symptoms,and the operation is relatively simple,without the need of metal internal fixation. |
| KEY WORDS Double-door laminoplasty Cervical spinal stenosis Dome decompression Posterior ligamentous complex |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 孙宜保,李毅力,杨勇.颈后路双开门椎管扩大成形术联合C2穹隆式减压治疗颈椎管狭窄症[J].中国骨伤,2020,33(2):181~183 |
| 英文格式: | SUN Yi-bao,LI Yi-li,YANG Yong.Double-door laminoplasty combined with C2 dome decompression for the treatment of cervical spinal stenosis[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(2):181~183 |
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