带线锚钉固定与微型钛板固定在颈椎后路单开门椎管扩大成形术中的应用效果比较-外科学专业论文.docx

山西医科大学硕士学位论文 山西医科大学硕士学位论文 I I 带线锚钉固定与微型钛板固定在颈椎后路单开门椎管扩大成形 术中的应用效果比较 摘 要 目的： 比较带线锚钉固定与微型钛板固定在颈椎后路单开门椎管扩大成形术中的应用 效果。 方法： 回顾性分析我院 2010 年 1 月至 2012 年 6 月因多节段脊髓型颈椎病分别采用颈后 路单开门带线锚钉固定与颈后路单开门微型钛板固定治疗的病例，比较两组在手术时 间、术中出血量、术后 JOA 评分、最窄椎管面积、并发症等方面的差异。 结果： 手术时间及术中出血量：带线锚钉组与微型钛板组组间差异有统计学意义；JOA 评分：术前及术后 1 周，带线锚钉组与微型钛板组组间差异无统计学意义，术后两年， 组间差异有统计学意义，微型钛板组评分高于带线锚钉组；最窄椎管面积：术前及术 后 1 周，组间差异无统计学意义，术后两年，组间差异有统计学意义，微型钛板组最 窄椎管面积大于带线锚钉组；并发症：两组患者切口均为甲级愈合，未出现伤口感染、 脑脊液漏等严重并发症。 结论： 颈椎后路单开门椎管扩大成形术的两种固定方法均能增加脊髓受压患者病变部 位的椎管面积，有效改善患者神经功能，微型钛板固定虽有手术时间长、出血量大等 缺点，但能有效防止再关门现象，具有更好的远期疗效。 关键词：微型钛板；带线锚钉；多节段脊髓型颈椎病；颈后路单开门椎管扩大成形术 Comparison of clinical effect of expansive open-door laminoplasty using suture anchor and micro titanium plate Abstract Objective: To observe the clinical curative effects of suture anchor and micro titanium plate in expansive open-door laminoplasty surgery. Methods: Data of 35 patients with multiple-segment cervical spinal cord compression who had been treated with expansive open-door laminoplasty using suture anchor and micro titanium plate were retrospectively analyzed.The operative time,blood loss,JOA scores,minimal cross-sectional area of the vertebral canal and complications were compared between the 2 groups. Results: Operative time and blood loss:There were significant differences between the suture anchor group and micro titanium plate group. JOA scores:Before treatment and one week after the treatment, There were no significant differences between the suture anchor group and micro titanium plate group.Two years after treatment, There were significant differences between the two groups,the micro titanium plate group were higher than that of the suture anchor group. Minimal cross-sectional area of the vertebral canal: Before treatment and one week after the treatment, There were no significant differences between the suture anchor group and micro titanium plate group.Two years after treatment, There were significant differences between the two groups,the micro titanium plate