颈椎后路单开门椎管扩大成形术后轴性症状探究进展.docVIP

颈椎后路单开门椎管扩大成形术后轴性症状探究进展 　　[摘要] 颈椎后路椎管扩大成形术是治疗多节段脊髓型颈椎病、发育性/退变性颈椎管狭窄、颈椎后纵韧带骨化症的经典术式，手术近远期疗效好。但是有些患者在手术后可以出现轴性症状，并且发病率高，严重时会影响患者的生活和工作。术后轴性症状发生的确切机制尚不完全清楚，目前认为主要和颈椎后伸机制的破坏及颈椎活动度的减少有关。目前对轴性症状的治疗尚无特效方法，大部分学者通过对传统颈后路单开门椎管扩大成形术进行改良来减少轴性症状的发生 [关键词] 轴性症状；单开门椎管扩大成形术；脊髓型颈椎病；研究进展 [中图分类号] R687.3 [文献标识码] A [文章编号] 1673-9701（2017）04-0164-05 Research progress on axial symptoms of cervical posterior open-door laminoplasty LV Fubao1 SONG Wenhui2 1.Shanxi Medical University，Taiyuan 030001，China； 2.Department of Spinal surgery，the Second Hospital of Shanxi Medical University，Taiyuan 030001，China [Abstract] Laminoplasty is a classic surgical procedure which has achieved good efficiency in both short-term and 1ong-term fellow-up result in the treatment of multi-segment cervical spondylotic myelopathy，developmental cervical spinal canal，degenerative cervical spinal canal stenosis and ossification of the posterior longitudinal ligament. However，many patients who were procedured cervical spine surgery emerge the complication of axial symptom and the rate of this complication is very high.The serious axial symptom will affect the patient’s life and work.Although the precise pathological mechanism of axial symptoms is unclear yet，most of surgeons consider that it is related to the damage of cervical extension mechanism and the decrease of range of motion of cervical spine.There is no efficient treatment for axial symptom nowadays，so most of researchers reduce the incidence of this complication by improving the traditional laminoplasty. [Key words] Axial symptom；Laminoplasty；Cervical spondylotie myelopathy；Research progress 颈椎病的发病率在逐渐上升并呈低龄化趋势。在颈椎病的分型中，脊髓型颈椎病危险最大，早期手术有良好的效果。颈后路单开门椎管扩大成形术是治疗脊髓型颈椎病（多节段）、颈椎管狭窄（发育性/退变性）、颈椎后纵韧带骨化症（ossification of posterior longitudinal ligament，OPLL）的一种常用手术方式，近远期随访结果证实，该术式在解除神经压迫，改善神经症状都具有切实、长久的疗效。它通过扩大颈椎管，借助“弓弦效应”使脊髓向后漂移，使颈脊髓腹侧得到间接减压，该术式对于3 个节段的脊髓型颈椎病变有独特优势[1]。但是该手术术后常会遗留或出现颈肩背部疼痛、颈肌僵硬以及颈部活动受限等症状，Kawaguchi Y等[2]在1999年首次定义这组症状为颈椎轴性症状（axial sy