摘要
背景:多节段颈椎病常见于老年患者,颈椎管成形和椎板切除是目前最常用的修复方法,C_5神经根麻痹是颈椎后路修复后多见的并发症。目的:比较颈椎管成形微钛板固定与椎板切除内固定修复多节段脊髓型颈椎病后C_5神经根麻痹的发生率。方法:2010年8月至2014年12月纳入多节段脊髓型颈椎病患者134例,因修复方式不同分为两组,椎管成形组45例接受颈椎管成形微钛板固定,颈板切除组89例接受椎板切除内固定。记录并评估修复后C_5神经根麻痹情况,比较两组间的颈椎前凸角度(Cobb角)及颈椎曲度指数,采用日本骨科协会评分评定神经功能。结果与结论:两组患者均获得随访,随访时间超过6个月。两组患者治疗前及治疗后1周颈椎前凸角度、颈椎曲度指数间差异无显著性意义(P>0.05)。两组患者治疗后6个月日本骨科协会评分均较治疗前有明显改善(P<0.05)。椎管成形组治疗后2例发生C_5神经根麻痹,发生率为4%(2/45);椎板切除组10例发生C_5神经根麻痹,发生率为11%(10/89),两组比较差异有显著性意义(P<0.05)。提示与椎板切除内固定相比,颈椎管成形微钛板固定后C_5神经根麻痹的发生率更低,其可广泛应用于多节段颈椎疾病的减压修复治疗。
BACKGROUND： Laminoplasty and laminectomy are the most commonly used treatment methods for multilevel cervical spondylotic myelopathy, which is more common in elderly patients. C5nerve root palsy is the common postoprative complication after posterior cervical repair. OBJECTIVE： To compare the incidence of C5 nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation In repair of multilevel Cervical spondylotic myelopathy. METHODS： Totally 134 patients with multilevel cervical spondylotic myelopathy from August 2010 to December 2014 were enrolled, and then divided into laminoplasty group （n=45） and laminectomy group （n=89） owing to different ways of repair. Patients in the laminoplasty group were treated with laminoplasty with mini-titanium plate fixation, and patients in the laminectomy group were treated with laminectomy with internal fixation. C5 nerve root palsy condition after repair was recorded and evaluated. The cervical lordosis angle （Cobb angle） and cervical curvature index were compared. The Japanese Orthopaedic Association score was used for neurological assessment. RESULTS AND CONCLUSION： All patients in both groups were followed up for more than 6 months. There were no significant differences in cervical lordotic angle and cervical curvature index at the first week before and afterthe treatment between these two groups （P 〉 0.05）. The Japanese Orthopaedic Association scores of patients after 6 months of treatment were significantly improved compared with that before treatment in these two groups （P 〈 0.05）. There were 2 cases of C5 nerve root palsy after the treatment of laminoplasty, the occurrence rate was 4% （2/45）; there were 10 cases of C5 nerve root palsy after the treatment of laminectomy, the occurrence rate was 11% （10/89）; there was significant difference between these two groups （P 〈 0.05）. These results suggest that compared with laminectomy fixation; the incidence of C5 nerve root palsy was lower after the laminoplasty with mini-trianium plate fixation, which can be widely used in decompression repair treatment of multilevel cervical spondylotic myelopathy.
出处
《中国组织工程研究》
CAS
北大核心
2015年第53期8554-8559,共6页
Chinese Journal of Tissue Engineering Research
关键词
内固定器
颈椎
脊柱融合术
随访研究
组织工程
Internal Fixators
Cervical Vertebrae
Spinal Fusion
Follow-up Studies
Tissue Engineering
