[摘要] [背景] 观察颈椎后路改良大Z形交叉式单开门椎管扩大成形术治疗脊髓型颈椎病的疗效. [病例报告] 对27例脊髓型颈椎病患者实施大Z形交叉式单开门椎管扩大成形术，通过术前及术后影像学观察及用JOA17分法进行近期疗效分析.平均随访14个月，JOA评分从术前平均8.4分改善到术后平均13.7分.影像学检查示术前22例颈椎前突型患者在术后随访时3例转变为直线型;术前5例颈椎直线型患者在术后随访时仍均保持直线型.术后颈椎前后活动度与轴性疼痛的发生相关. [讨论] 采用改良大Z形交叉式单开门椎管扩大成形术治疗脊髓型颈椎病，具有减压彻底、椎管扩大充分、防止再关门等优点，是简便、安全且有效的方法.

    [关键词] 颈椎病;手术，外科;椎管

    Operative procedure of Z-open-door expansive laminoplasty for27cases of cervical spondylotic myelopathy

    YUAN Hu，ZHU Ying-jun，LI Yang，FENG Zhen，CHEN Ji-liang，ZHENG Guang-bin

    (Department of Orthopedic Surgery，Affiliated Hospital of Yanbian University，Yanji133000，Jilin，China)

    ABSTRACT:BACKGROUND To investigate the therapeutic effects of cervical spondylotic myelopathy(CSM)by expansive Z-open-door laminoplasty.CASE REPORTS27cases of CSM were operated with expansive Z-open-door laminoplasty，and followed up in an average of14months.The therapeutic effects were observed by imaging examination and the method of JOA scores in before and after operation.The JOA scores of the cases were improved as13.7after operation ......