颈椎后路单开门微型钛板固定治疗多节段脊髓型颈椎病临床应用

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1、颈椎后路单开门微型钛板固定治疗多节段脊髓型颈椎病临床应用【摘要】目的：讨论颈椎后路单开门微型钛板固定术在治疗多节段脊髓型颈稚病的临床应用及其近期随访结果。方法：自2010年3月-2012年3月在我院行颈椎后单开门微型钛板固定术并获得完整随访病例的脊髓型颈椎病患者42例，手术开门减压节段均为C3-C7,术中将预弯成“Z”形的6孔微型钛板两端分别固定于开门后的椎板和门轴侧侧块上，用以取代传统的丝线悬吊固定法。通过影像学及临床表现观察所有病例的治疗效果。结果：所有患者据均未出现术中神经、血管损伤等并发症。患者术后随访6-12个月，平均9个月，影像学检查显示内固定牢固

2、，未见钛板及钛钉脱落、移位、椎板折弯塌陷及再关门现象。术后JOA评分较术前明显提高；术前平均8.9(7-11)分，术后13.2(8-16)分；术后JOA平均改善率52.82%(15.6%-80.5%)；术后6个月JOA平均改善率54.25%(17.94%-84.75%)。术后颈椎轴性症状(AS)的评价；术后6个月AS平均改善率65.4%(24.8%-86.0%)o结论：颈椎后路单开门微型钛板固定术治疗多节段脊髓型颈椎病疗效确切，操作简便，神经功能及临床症状得到明显恢复及改善，值得临床推广。【关键词】颈椎病；椎管扩大椎板成形术；单开门；微型钛板【中图分类号】R6

3、87【文献标识码】A【文章编号】1004-7484(2013)05-0776-02Posteriorcervicalsingledoorminiaturetitaniumplatefixedtreatmentofmulti-segmentcervicalspondyloticmyelopathyofclinicalapplicationSongYangl*YangYanJunl**ChengWei1*(NorthChinauniversityaffiliatedhospitalboneoutside2thfamiliesJiLin132400)[Abstrac

4、t]0bjective：Talkaboutposteriorcervicalsingledoorminiaturetitaniumplatefixationinthetreatmentofmulti-segmentcervicalspondyloticmyelopathy(MCSM)clinicalapplicationandrecentfollow-upresults.Methods：FromMarch2010toMarch2012,atotalof42caseswithmulti-segmentcervicalspondyloticmyelopathy(M

5、CSM)operationaftercervicalsingledoorminiaturetitaniumplatecompanionandobtaincompletefollow-upinourhospita1.Allpa/tientshaddecompressionrangefromC3toC7.Operationwillbendinginto"Z”form6holeminiaturetitaniumplaterespectivelyonbothendsfixedinopenedthedoorofthevertebralplateandgateshafts

6、ideoftheblock.Toreplacethetraditionalsilksuspensionfixedmethod.Throughtheimagingandclinicalmanifestationtoobservethetherapeuticeffectofallcases.Results：Allpatientsaccordingtoalldidnotappearintraoperativecomplicationssuchasnerve,bloodvesseldamage,themeanfollow-upwas9months(6-12months

7、),radiographicinspectiondisplayinnerfixedfirmly,therewasnoscrewlooseningandrecloseoftheopenedlaminae・PostoperativeJOAscoreincreasedalotaftertheoperations；preoperativeanaverageof8.9(7-11)points,postoperative13.2(8~16)points；postoperativeJOAperiodaverage52.82%(15.6%一80・5%)；after6month

8、speriodJOAaverage54