颈椎管狭窄；_颈半棘肌;_矢状序列;

保留颈半棘肌肌止的椎板成形术的临床应用

http://www.100md.com 《中华首席医学网》 2006年第13期

颈椎管狭窄；,颈半棘肌;,矢状序列;,轴性症状;,椎板成形术,,颈椎管狭窄；,颈半棘肌;,矢状序列;,轴性症状;,椎板成形术,1材料与方法,2结果,3讨论

     摘要：[目的]研究确定行颈椎单开门椎板成形术时完整保留C2颈半棘肌肌止是否能有效维持颈椎术后矢状序列，降低术后颈椎轴性症状的发生。[方法]2002年3月~2003年12月，本院行保留颈半棘肌肌止的椎板成形术48例，其中32例获得至少2 a的随访列为试验组，对患者术前、术后的JOA评分、颈椎轴性症状严重程度、颈椎曲度指数、颈椎活动度进行比较评估。[结果]本组患者术前、术后JOA评分分别为(90±29)和(125±31)，恢复率(449±269)。手术前、后有明显症状颈椎轴性症状的患者比例分别为468%和187%，差别有统计学意义(P<005)。手术前后患者颈屈指数、颈椎活动范围等指标无统计学意义差别。[结论]保留颈半棘肌肌止的椎板成形术可以减少对颈椎后伸机理的破坏，有效维持术后颈椎矢状序列减少轴性症状的发生。

    关键词：颈椎管狭窄；颈半棘肌; 矢状序列; 轴性症状; 椎板成形术

    Clinical application of the modified opendoor laminoplasty perserving semispinalis cervicis insert into axis∥ZHANG Wei,DONG Yuchang,SHEN Yong,et alDepartment,the Third Hospital Affiliated to Hebei Medical University,Shijiazhuang,Hebei Provience,050051，China

    Abstract：[Objective]To verify whether or not the modified opendoor laminoplasy preserving semispinalis cervicis insert into axis is effective in preventing postoperative axial symptom and maintaining postoperative cervical sagittal alignment[Method]Since March 2002 to December 2003,fortyeight patients underwent modified opendoor laminoplasy preserving semispinalis cervicis insert into Axis,among them,thirtytwo patients who were followed up for more than 2 years were included in this studyPreoperative and postoperative JOA score,degree of axial symptom,ranges of neck motion,cervical curvature index were recorded and compared[Result]Preoperative and postoperative JOA score was(904±29)and(125±31)respectively,with recovery rate as(449±269)There was significant difference between preoperative evident axil symptom rate(468%)and postoperative evident axil symptom rate(187%),while no significant difference between preoperative and postoperative ranges of neck motion,cervical curvature index was seen[Conclusion]Modified opendoor laminoplasy is less invasive to the posterior extensor mechanism especially the semispinalis cervicis than conventional opendoor laminoplasyThis new procedure is effective in preventing postoperative morbidities often seen after conventional laminoplasy with adequate decompression of the spinal cord ......

百拇医药网 http://www.100md.com/html/DirDu/2006/07/27/12/26/08.htm

您现在查看是摘要页，全文长 9326 字符。