You Position: Home > Paper
Clinical application of lower cervical spinous process laminar screw technique in open door laminoplasty
( views:295, downloads:44 )
- Author:
- No author available
- Journal Title:
- China Journal of Orthopaedics and Traumatology
- Issue:
- 9
- DOI:
- 10.3969/j.issn.1003-0034.2012.09.003
- Key Word:
- 颈椎病;椎管狭窄;外科手术;单开门椎管扩大术
Abstract： 目的:探讨下颈椎棘突椎板螺钉技术在单开门椎管扩大术中的临床应用及疗效.方法:2005年2月至2010年6月,采用下颈椎棘突椎板螺钉技术治疗颈椎病12例,男7例,女5例；年龄34～78岁,平均56岁；其中前方椎间盘退变突出合并退变性椎管狭窄者6例,后纵韧带骨化伴骨赘形成者5例,颈椎外伤性失稳伴脊髓损伤1例.对患者临床疗效和影像学情况进行评估,包括神经功能(依照JOA评定),术后并发症,颈椎各节段矢状径比例、屈伸活动范围及矢状序列的改变(利用影像学资料进行测量).结果:手术时间1.5～2 h,平均110 min；术中出血量450～800 ml,平均580 ml.术后出现上肢疼痛1例,脑脊液漏1例.12例均获随访,时间1～2年,平均21.8个月.JOA评分术前为(9.5±1.8)分,术后为(13.6±2.4)分(P＜0.01).术后CT、MRI显示颈椎管矢状径比例增加(P＜0.01).颈椎屈伸活动范围、前凸比例由术前的(40.0±10.0)°、(65.0±12.0)％降至术后的(15.0±5.0)°、(42.0±8.0)％(P＜0.01).结论:下颈椎棘突椎板螺钉技术应用于单开门椎管扩大术中治疗颈椎病能取得满意疗效,相对安全、操作简单,并且具有较强内固定、可防止再关门.
- [1]刘子祯,张静,郭永贤,等.颈椎后前联合手术入路治疗脊髓型颈椎病[J].2010,(7).
- [2]张卫,翟建国,翟英,等.颈椎后路手术后硬膜外血肿形成2例[J].2006,(2).
- [3]T T, Lee,B A, Green,E B, Gromelski.Safety and stability of open-door cervical expansive laminoplasty.[J].1998,11(1).
- [4]Nakamura M,Matsumoto M,Takaishi H,etc.Risk factors for closure of lamina after open-door laminoplasty.[J].2008,9(6).
- [5]Nakamura M,Chiba K,Ishii K,etc.Long-term results of expansive open-door laminoplasty for cervical myelopathy--average 14-year follow-up study.[J].2006,31(26).
- [6]K, Hirabayashi,K, Watanabe,K, Wakano,etc.Expansive open-door laminoplasty for cervical spinal stenotic myelopathy.[J].1983,8(7).
- [7]Heller JG,Park AE.Cervical laminoplasty: use of a novel titanium plate to maintain canal expansion--surgical technique.[J].2004,17(4).
- [8]Green BA,Wang MY.Open-door Cervical Expansile Laminoplasty.[J].2004,54(1).
- [9]Hanks SE,Oxner W,Lee JY,etc.Use of small suture anchors in cervical laminoplasty to maintain canal expansion: a technical note.[J].2007,20(1).
- [10]KIYOSHI HIRABAYASHI,KAZUHIKO SATOMI.Operative Procedure and Results of Expansive Open-Door Laminoplasty[J].1988,13(7).
- [11]Mukai Y,Sakaura H,Hosono N,etc.Preservation of muscles attached to the C2 and C7 spinous processes rather than subaxial deep extensors reduces adverse effects after cervical laminoplasty.[J].2010,35(16).
- [12]Tokuhashi Y,Matsuzaki H,Uematsu Y.Radiculopathy after laminoplasty of the cervical spine.[J].1998,23(19).
- [13]T, Itoh,H, Tsuji.Technical improvements and results of laminoplasty for compressive myelopathy in the cervical spine.[J].1985,10(8).
- [14]Chen C,Kallakuri S,Cavanaugh JM,etc.Pain generation in lumbar and cervical facet joints.[J].2006,88(Suppl.2).
- [15]Okada M,Minamide A,Endo T,etc.A prospective randomized study of clinical outcomes in patients with cervical compressive myelopathy treated with open-door or French-door laminoplasty.[J].2009,34(11).
- [16]K, Hirabayashi,Y, Toyama,K, Chiba.Expansive laminoplasty for myelopathy in ossification of the longitudinal ligament.[J].1999,(359).
- [17]Ito M,Suda K,Shono Y,etc.Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy.[J].2003,28(12).
- [18]Bunmaprasert,Buchowski JM,Liu G.Revision surgery following cervical laminoplasty: etiology and treatment strategies.[J].2009,34(25).
- [19]Iencean SM.Alternating cervical laminoplasty for cervical spondylotic myelopathy.[J].2007,89/B(5).
- [20]Takeshi, Hori,Yoshiharu, Kawaguchi,Tomoatsu, Kimura.How does the ossification area of the posterior longitudinal ligament thicken following cervical laminoplasty?[J].2007,32(19).