丁立祥;陈迎春;姚琦;张亘瑷;董福慧;

• 1:北京世纪坛医院
• 2:中国中医研究院骨伤科研究所

摘要(Abstract)：

[目的]对传统C3～7椎板成形术进行改良,观察改良手术疗效,探讨其能否有效降低并发症的发生。[方法]改良椎板成形术治疗脊髓型颈椎病20例(A组),A组患者平均年龄65.7岁(45～83岁);男14例,女6例;平均随访时间为18个月(12～27个月)。传统术式对照组(B组)为本院同期行传统C3～7椎板成形术的18例患者,B组患者平均年龄59岁(46～75岁);男11例,女7例;平均随访时间为25个月(12～50个月)。对两组患者手术前后的JOA评分、颈椎曲度角度、颈椎活动度及轴性症状严重程度进行比较评估。[结果]JOA评分恢复率,A组患者为46.5%,B组患者为54.1%,两组差异无统计学意义(P>0.05)。A组术后有明显轴性症状患者的比例为10%,B组为44.4%,两组比较差异有统计学意义(P<0.05)。A组患者术后颈椎曲度Cobb’s角11.2°±9.2°,B组患者术后颈椎曲度Cobb’s角10.9°±10.1°,A组和B组患者手术前后颈椎曲度的变化差异无统计学意义(P>0.05)。A组患者术后颈椎活动度丢失6.9°±4.0°,B组患者术后颈椎活动度丢失11.6°±7.8°,两组差异有统计学意义(P<0.01)。[结论]C3椎板切除保留C2棘突半棘肌附着、同时保留C7棘突颈背肌肉附着的颈椎管扩大椎板成形术能获得良好神经减压效果,同时可以最大程度维持颈半棘肌和颈背肌结构和功能的完整性,减少对颈椎后伸机制和颈椎稳定机制的破坏,从而保留颈椎的活动度和降低术后颈椎轴性症状的发生。

关键词(KeyWords)： 颈椎病;椎板切除术;椎板成形术

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 丁立祥;陈迎春;姚琦;张亘瑷;董福慧;

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DOI:

参考文献(References)：

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