【摘要】 目的研究颈椎后路单开门Centerpiece钛板系统对多节段脊髓型颈椎病治疗的早期临床疗效。方法 35例因脊髓型颈椎病病人行颈椎后路C3-C7单开门Centerpiece钛板内固定术治疗,在术前及术后12个月时以日本骨科协会(JOA)评分(17分法)量表评分,计算术后神经功能改善率。于术前及术后7天、术后6个月、术后12个月行颈椎X线、CT、MRI影像学检查。通过术前及术后12个月的CT图像测量C5椎管矢状径,计算出早期椎管扩大率。通过术前及术后12个月的颈椎X片测量颈椎Cobb角,分析颈椎曲度情况。结果所有病人均获得12～24个月的随访。术后复查颈椎MRI及三维CT,均显示椎管明显扩大,单开门门轴稳定,无椎板塌陷。术前JOA评分为(8.43±1.09)分,术后12个月为(13.94±1.66)分,术后神经功能改善率为(65.68±16.15)%。C5节段椎管矢状径术前及术后12个月分别为(9.49±1.30)mm和(16.70±1.97)mm,椎管扩大率为(76.88±14.66)%。颈椎曲度末次随访时较术前呈减小变化,差异有统计学意义(P<0.05)。结论 Centerpiece固定系统的颈椎后路单开门椎管扩大成形术在多节段脊髓型颈椎病的治疗中安全有效,术后神经功能恢复明显,早期疗效满意。更多还原

【Abstract】 Objective To investigate the early clinical effects of posterior cervical single-door laminoplasty plus centerpiece titanium plate fixation for multi-segmental cervical spondylotic myelopathy.Methods 35 patients suffering from cervical spondylotic myelopathy who underwent C3-C7 single-door centerpiece titanium plate fixation were reviewed retrospectively.The neurofunction was evaluated by comparing Japan Orthopaedic Association(JOA)score measured before and 12 months after surgery.X-ray,CT and MRI were performed before operation,7 days after operation,6 months after operation and 12 months after operation.The sagittal diameter of C5 spinal canal on the CT was measured before operation and 12 months after operation respectively,and the expansion rate of C5 spinal canal was calculated.The C2-C7 Cobb angle were measured to evaluate cervical curvature by means of X-ray measured before and 12 months after surgery.Results All patients were followed up for 12～24 months.Radiographic findings at follow-up period showed spinal canal enlarged perfectly,and no door closing or instrument failure.The average JOA score for preoperation was(8.43±1.09)and(13.94±1.66)at 12 months after operation,with the improvement rate of(65.68±16.15)%.The mean sagittal diameter of C5 spinal canal was(9.49±1.30)mm before operation and(16.70±1.97)mm at 12 months,with the improvement rate of(76.88±14.66)%.The C2-C7 Cobb angle had a decreasing trend at the 12 months follow-up compared with preoperative values,and there was significant difference(P<0.05).Conclusion Posterior cervical single-door laminoplasty plus centerpiece titanium plate fixation is reliable,nerve therapeutic effect and early clinical efficacy is satisfactory.更多还原