单开门椎管扩大椎板成形术保留一侧肌肉韧带复合体治疗多节段脊髓型颈椎病.docVIP

单开门椎管扩大椎板成形术保留一侧肌肉韧带复合体治疗多节段脊髓型颈椎病 　　[摘要] 目的 分析单开门椎管成形术中保留一侧肌肉韧带复合体对多节段脊髓型颈椎病的临床效果。 方法 随机选取我院2010年1月～2013年1月对多节段脊髓型颈椎病患行单侧肌肉韧带复合体治疗的患者42例，其中男22例，女20例，年龄35～78岁，平均57.5岁，根据术前术后病患的JOA评分判断其颈椎生理曲度和活动范围（ROM）。 结果 对于采取手术的42例患者进行1～4年的随访工作，平均为2.5年，其JOA的评分值是8～13分，平均值为9.5分，最后一次随访评分平均值为14.3分，相对于手术前有显著好转（P0.05），手术之后的颈椎前突并没有明显减少，经过手术的病患没有出现后凸畸形的情况，患者的颈椎活动范围术后比术前减少，平均ROM值为26.9°，术前相应数值为39.8°，差异明显（P0.05），过屈位15.4°，相较于术前24.3°，差异有统计学意义（P0.05）。 结论 在多节段脊髓型颈椎病中应用一侧肌肉韧带复合体椎板成形术具有较好的临床效果，可以显著降低轴性症状，维持较好的颈椎活动度。 　　[关键词] 颈椎椎板成形术；轴性症状；颈椎运动功能；多节段脊髓型颈椎病 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2015）30-0036-03 　　Single open-door spinal-expansion cervical laminoplasty to retain one side muscle ligament complex in the treatment of multiple segments cervical myelopathy 　　GUO Zhaoyang ZHANG Shufang LI Mingheng CHEN Rongchun 　　Department of Spinal Surgery， Ganzhou Hospital Affiliated to Nanchang University， Ganzhou 341000， China 　　[Abstract] Objective To explore the clinical efficacy of single open-door cervical laminoplasty to retain one side muscle ligament complex in the treatment of multiple segments cervical myelopathy. Methods 42 cases of patients with multiple-segment cervical myelopathy receiving one side muscle ligament complex treatment in our hospital from January 2010 to January 2013 were randomly chosen， including 20 females and 22 males， aging from 35 to 78 years old， with an average age of 57.5. According to the patients preoperative and postoperative JOA scores， their cervical lordosis and range of motion （ROM） were determined. Results The 42 patients who were given surgery， received follow-up work for 1 to 4 years， with an average of 2.5 years. The JOA score ranked from 8 to 13 points， with an average of 9.5 points ，and the average of the last follow-up score was 14.3 points， with significant improvement compared with the pro-surgery score（P0.05）. Anterior cervical spine after surgery did not significantly reduce， and kyphosis did not occur in patients after surgery. Compared