全椎板切除后椎管重建在颈椎管狭窄症中的临床应用研究.PDFVIP

298 颈腰痛杂志2009 年第30 卷第4 期 The Journal of Cervicodynia and Lumbodynia 2009 ，Vol．30 No．4 · · 临床论著 · · 全椎板切除后椎管重建在颈椎管狭窄症中 的临床应用研究 贺瑞，尚希福，张文志，胡业丰，许翔，朱亚林，史国光，胡飞，姚刚 （安徽医科大学附属省立医院骨二科，安徽 合肥 230001） 摘要：目的 探讨应用全椎板切除后椎管重建在颈椎管狭窄症中的效果。方法 20005 年2 月 至2007 年12 月对48 例椎管狭窄症的患者。后路全椎板切除椎管减压后应用植骨法行椎管扩大成 行。所有患者做术前、术后的JOA 评分，并术前、术后行X 线、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，脊髓受压解除。结论 应用全椎板切除后椎管 重建在颈椎管狭窄症治疗中疗效满意，是一种新的治疗颈椎管狭窄症方法。 关键词：颈椎；椎管成形；植骨；椎管狭窄 中图分类号：R687.3 文献标识码：A 文章编号：1005-7234 （2008）04-0298-04 Clinical exploratory development of removal vertebral plate to rebuild canalis vertebralis for treatment of cervical spinal stenotic myelopathy HE Rui，SHANG Xi-fu ，ZHANG Wen-zhi ，et .al. （Section II ，Department of Orthopedics ，The Provincial Hospital Affiliated to Anhui Medical Univer－ sity，Hefei Anhui 230001 ，China） Abstract ：Objective To study the results of using removal vertebral plate to rebuild canalis vertebralis for treatment of cervical spinal stenotics. Methods 48patients ，removal vertebral plate to rebuild canalis vertebralis.The clinical outcomes were evaluated according to the score Japanese Orthopedic Association （JOA）before and after the operation. Finished X-ray and CT ，MRI before and after the operation. Results All patients had been followed up over 3 months. The average follow up time were 15 months. After operation ，the JOA score improved from 6.85 to 13.50 paints ，enlarge the sagittal diameter of vertebral canal and living of bone graft were confirmed by 3D CT MRI showed that spinal cord was retrusion and relieved compression obviously. Conclusion