后路减压固定三明治植骨椎管扩大成形术治疗颈椎管狭窄症.pdfVIP

·352· ·论著· 后路减压固定“三明治”植骨椎管扩大成形术 治疗颈椎管狭窄症 张文志，贺瑞，尚希福，胡业丰，许翔，朱亚林，史国光 (安徽医科大学附属省立医院、安徽省立医院骨二科，合肥230001) [摘要] 目的探讨后路减压固定“三明治”植骨颈椎管扩大成形术的效果。方法对58例颈椎管狭 窄症的患者，后路全椎板切除椎管减压固定后应用“三明治”植骨法行椎管扩大成形术。所有患者做术前、术 后的JOA评分，并术前、术后行x线摄片、三维CT，MRI检查观察颈椎管容积、脊髓信号、植骨融合情况。结 果所有的患者行3个月以上随访，平均随访时间为15个月。临床评分：手术前平均JOA评分6．85分，手术 后平均9．65分，末次随访时平均13．50分，术后三维CT提示植骨成活，椎管管径扩大；MRI检查显示：脊髓后 移3—6 mm，脊髓受压解除。结论应用“三明治”植骨行颈椎后路椎管扩大成形术疗效满意，是一种新的治 疗颈椎管狭窄症方法。 [关键词]椎管狭窄；外科手术；减压术，外科；椎板切除术 [文献标识码】A [文章编号]1672-6790(2010)04-0352-02 [中图分类号]R681．531．4 Treatmentofcervicalstenosiswith fixationand sandwichbone posterior expansive using spine laminoplasty ZHANG graft Wen-zhi，HERui，SHANG施-fu，HUYe-feng，XUXiang，ZHUYa—lin，SHI Guo—guang(Departmentof Provincial Medical Orthopaedics，theAffiliated HospitalofAnhui University，Hefei230001，China) To theeffectsof andsandwich cervical [Abstract]．Objectivestudy decompression，fixationbone础in 58 ofcervicalstenosisweretreatedwith posteriorexpansivelaminoplastyoperation．Methodspatients spine posteri— or and sandwichbone clinicaloutcomeswereevaluated decompression，fixationexpansivelaminoplastyusing graft．The tothescore examinationof according JapaneseOrthopedicAssociation(JOA)ofpre-andpost—operation．The X-ray and were beforeandafterthe All werefouowedforan of CT，MRlperformed operation．Resultspatients up average 15 from3to47 scalesincreasedfrom months)．TheJOA 6．85to 13．50． months(range preoperativepostoperative The