2019 年第 11 期 第 14 卷

颈椎单开门微型钛板固定成形术不同开门角度对多节段脊髓型颈椎病患者轴性症状及脊髓神经功能的影响

Effect of different lamina angles in unilateral open-door laminoplasty with titanium mini-plate fixation on axial symptoms and spinal nerve function in patients with multilevel cervical spondylotic myelopathy

作者：李海涛孙丽静

英文作者：

单位：056001河北省邯郸市中心医院骨二科（李海涛）；056001河北省邯郸市第七医院手术室（孙丽静）

英文单位：

关键词：颈椎单开门微型钛板固定成形术；多节段脊髓型颈椎病；轴性症状；脊髓神经功能

英文关键词：

• 摘要：

• 【摘要】目的    探究颈椎单开门微型钛板固定成形术不同开门角度对多节段脊髓型颈椎病患者轴性症状及脊髓神经功能的影响。方法    选取河北省邯郸市中心医院2017年1月至2019年1月收治的多节段脊髓型颈椎病患者78例，根据术后3个月复查椎板开门角度，分为A组（24.5°～36.5°）和B组（36.6°～49.0°），每组39例。比较2组患者的手术情况、日本骨科协会（JOA）脊髓神经功能评分、颈椎曲度指数（CCI）及术后3个月轴性症状发生情况。结果    2组手术时间、术中出血量、住院时间比较，差异均无统计学意义（均P＞0.05）。2组术前、术后的JOA评分和CCI组间比较差异均无统计学意义（均P＞0.05）；2组术后JOA评分均较术前升高、CCI均较术前降低［A组：（13.8±3.6）分比（8.6±2.0）分、（13±4）%比（14±4）%，B组：（14.2±3.7）分比（8.8±2.1）分、（13±4）%比（14±4）%］，差异均有统计学意义（均P＜0.05）。A组轴性症状发生率低于B组［10.3%（4/39）比28.2%（11/39）］，差异有统计学意义（P＝0.044）。结论    颈椎单开门微型钛板固定成形术不同开门角度均可改善患者脊髓神经功能，但可造成颈椎曲度丢失，出现轴性症状，且开门角度越大，患者轴性症状发生率越高。

• 【Abstract】Objective    To explore the effect of different lamina angles in unilateral open-door laminoplasty with titanium mini-plate fixation on axial symptoms and spinal nerve function in patients with multilevel cervical spondylotic myelopathy. Methods    From January 2017 to January 2019, 78 patients with multilevel cervical spondylotic myelopathy were enrolled in Handan Central Hospital, Heibei Province. According to the lamina angle 3 months after operation, the patients were divided into group A(24.5°-36.5°, 39 cases) and group B(36.6°-49.0°, 39 cases). Operation records, Japanese Orthopaedic Association(JOA) score for spinal nerve function, cervical curvature index(CCI) and incidence of axial symptoms in 3 months after operation were analyzed. Results    There were no statistical differences in operation time, intraoperative blood loss, hospitalization time, pre- and post-operative JOA score and CCI between groups(all P＞0.05). JOA score significantly increased and CCI significantly decreased after operation in both groups［group A： （13.8±3.6） vs （8.6±2.0）, （13±4）% vs （14±4）%; group B： （14.2±3.7） vs （8.8±2.1）, （13±4）% vs （14±4）%］（all P＜0.05）. Incidence of axial symptoms in group A was significantly lower than that in group B［10.3%（4/39） vs 28.2%（11/39）］（P＝0.044）. Conclusions    Unilateral open-door laminoplasty with titanium mini-plate fixation treating multilevel cervical spondylotic myelopathy can effectively improve spinal nerve function but may cause loss of cervical curvatures and axial symptoms. The incidence of axial symptoms increases with lamina angle.