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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
Hits: 2615   Download times: 1417   Received:June 20, 2008    
作者Author单位UnitE-Mail
张学利 ZHANG Xue-li 天津市人民医院脊柱外科,天津 300121 Department of Spinal Surgery,the People's Hospital of Tianjin,Tianjin 300121,China zxlspine@yahoo.com.cn 
王善金 WANG Shan-jin 天津市人民医院脊柱外科,天津 300121 Department of Spinal Surgery,the People's Hospital of Tianjin,Tianjin 300121,China  
王云力 WANG Yun-li 天津市人民医院脊柱外科,天津 300121 Department of Spinal Surgery,the People's Hospital of Tianjin,Tianjin 300121,China  
刘献强 LIU Xian-qiang 天津市人民医院脊柱外科,天津 300121 Department of Spinal Surgery,the People's Hospital of Tianjin,Tianjin 300121,China  
期刊信息:《中国骨伤》2008年21卷,第10期,第759-761页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:观察评价锚定法单开门椎管成形术在降低术后轴性症状发生和减少颈椎曲度丢失中的作用。

方法:选择2004年10月至2007年5月行锚定法单开门椎管成形术并获得完整随访的患者56例(锚定单开门,A组),与50例同期行传统单开门手术的患者(传统单开门,B组)进行对比分析,记录手术时间、术中出血量、轴性症状及JOA(17分法)评分,根据X线片测量C2与C7椎体后壁切线夹角α。

结果:手术时间:A组(116.0±27.9) min,B组 (120.0±18.9) min,差异无统计学意义(P>0.05);术中出血量:A组 (148.0±68.3) ml,B组 (152.0±63.4) ml,差异无统计学意义(P>0.05);A组23例(41.1%)发生轴性症状或加重,B组38例(76.0%)发生轴性症状或加重,差异有统计学意义(P<0.05);JOA评分:A组改善率(61.1±24.5)%,B组改善率(53.3±23.3)%,差异有统计学意义(P<0.05);A组术前颈曲夹角(6.3°±5.1°)与术后颈曲夹角(6.6°±4.5°)比较无统计学意义(P>0.05),B组术前颈曲夹角(5.9°±5.1°)与术后颈曲夹角(4.8°±3.5°)比较有统计学意义(P<0.05).

结论:锚定法单开门椎管成形术能减少术后轴性症状的发生和颈椎曲度的丢失,有利于早期功能锻炼,能提高脊髓型颈椎病的治疗效果。
[关键词]:颈椎病  椎管成形术  轴性症状  颈椎曲度
 
The comparative study of effect of a modified open door laminoplasty using anchor method on axial symptoms and cervical curvature
Abstract:

Objective: To evaluate the effect of a modified open door laminoplasty using anchor method on reducing the occurrence of axial symptoms and loss of cervical curvature.

Methods: From October 2004 to May 2007,56 patients with cervical spondylotic myelopathy underwent this procedure and been followed up (group A). Another 50 patients who underwent conventional unilaterally open-door laminoplasty served as control (group B). The operation time,blood loss,JOA scores and the incidence of newly developed or deteriorated axial symptoms were recorded. Preoperative and postoperative curvature angle which was presented on the tangent of posterior vertebral body margins of C2 and C7 in the cervical spine were measured on cervical radiographs.

Results: The operative time was(116±27.9) min in group A and(120±18.9) min in group B,showing no statistically significant difference(P>0.05). The operative blood loss was(148±68.3) ml in group A and(152±63.4) ml in group B(P>0.05). According to JOA scores,the average recovery rates were(61.1±24.5)% in group A and(53.3±23.3)% in group B(P<0.05). Postoperative development or deterioration of axial symptoms occurred in 41.1% of patients in group A and 76.0% of patients in group B,showing statistically significant difference(P<0.05). There was no significant difference between preoperative(6.3°±5.1°)and postoperative(6.6°±4.5°) cervical curvature angle in group A,whereas the mean value of postoperative angle(4.8°±3.5°)was significantly smaller than that of preoperative one(5.9°±5.1°) in group B(P<0.05).

Conclusion: The modified open door laminoplasty using anchor method was effective on reducing the occurrence of axial symptoms and loss of cervical curvature and to the benefit of early functional training.
KEYWORDS:Cervical spondylosis  Laminoplasty  Axial symptoms  Cervical curvature
 
引用本文,请按以下格式著录参考文献:
中文格式:张学利,王善金,王云力,刘献强.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,2008,21(10):759~761
英文格式:ZHANG Xue-li,WANG Shan-jin,WANG Yun-li,LIU Xian-qiang.The comparative study of effect of a modified open door laminoplasty using anchor method on axial symptoms and cervical curvature[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(10):759~761
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