【摘要】：目的：驗證改良單開門椎管擴大成形治療慢性壓迫性頸脊髓病的臨床效果。方法：回顧性分析2010年1月至2013年12月在新疆醫(yī)科大學(xué)第一附屬醫(yī)院行后路單開門椎管擴大成形治療的慢性壓迫性頸脊髓病患者87例,其中改良組41例采用改良單開門椎管擴大成形治療,保留C7棘突及其附著肌肉韌帶組織,開門節(jié)段為C3-C6；對照組46例采用傳統(tǒng)C3-C7單開門擴大成形治療。記錄手術(shù)時間、術(shù)中出血量,對兩組患者治療前及治療后隨訪時的JOA評分(17分法)、頸椎曲度Cobb角、頸椎活動度及軸性癥狀嚴重程度等進行對比分析。結(jié)果：87例患者全部獲得隨訪,改良組手術(shù)時間(82.46±14.80)min,出血量(196.3±141.4)mL；對照組手術(shù)時間(78.41±15.43)min,出血量(220.91±128.21)mL,兩組差異無顯著性意義(P0.05)。JOA評分恢復(fù)率兩組差異無顯著性意義(P0.05)。改良組治療后有明顯軸性癥狀患者的比例為17%,對照組為46%,對照組顯著高于改良組(P0.05)。改良組治療后頸椎曲度丟失程度、頸椎活動度丟失程度均顯著小于對照組(P0.05)。兩組末次隨訪門軸側(cè)均骨性愈合,無椎板塌陷和再“關(guān)門”現(xiàn)象。結(jié)論：改良單開門椎管擴大成形治療能獲得良好的神經(jīng)減壓效果,同時可以最大程度維持頸后韌帶復(fù)合體結(jié)構(gòu)和功能的完整性,減少對頸椎穩(wěn)定機制的破壞,從而保留頸椎曲度、頸椎活動度,并降低術(shù)后軸性癥狀的發(fā)生。
[Abstract]:Objective: to verify the clinical effect of modified open-door spinal canal enlargement in the treatment of chronic compressive cervical myelopathy. Methods: from January 2010 to December 2013, 87 patients with chronic compression cervical myelopathy were treated by posterior open-door spinal canal reconstruction in the first affiliated Hospital of Xinjiang Medical University. In the modified group, 41 cases were treated with modified single-door laminoplasty, the C7 spinous process and its attached muscle ligament tissue were preserved, and the open door segment was C3-C6. The control group (46 cases) was treated with conventional C3-C7 open door expanded plastic therapy. The operation time, intraoperative bleeding volume, JOA score (17 points), Cobb angle of cervical curvature, cervical motion and severity of axial symptoms were compared and analyzed before and after treatment in the two groups. Results: all 87 patients were followed up. The operative time of the modified group was (82.46 鹵14.80) min, bleeding volume (196.3 鹵141.4) mL;. The operative time of the control group was (78.41 鹵15.43) min, bleeding volume (220.91 鹵128.21) mL, there was no significant difference between the two groups (P0.05). JOA score recovery rate (P0.05). The proportion of patients with obvious axial symptoms after treatment was 17 in the modified group, 46 in the control group, and significantly higher in the control group than in the modified group (P0.05). The degree of cervical curvature loss and cervical motion loss in the modified group were significantly lower than those in the control group (P0.05). In the last follow-up, bony healing was found in both groups, without laminar collapse and reclosing. Conclusion: the modified open door laminoplasty can obtain good neurodecompression effect, at the same time, it can maintain the integrity of the structure and function of the complex of posterior cervical ligament to the maximum extent, and reduce the destruction of the stability mechanism of cervical spine. Thus preserving cervical curvature, cervical motion, and reducing the incidence of postoperative axial symptoms.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
，

本文編號：2317399