颈椎后路单开门联合椎弓根螺钉固定治疗颈椎管狭窄症伴不稳

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (2206 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the the necessity and curative effect of posterior cervical open-door laminoplasty combined with pedicle screw fixation for cervical spinal stenosis with instability.Methods 31 cases of cervical stenosis with unstable patients were selected to record the operation time，intraoperative bleeding and complications.Using JOA score of Japanese Orthopaedic Association (JOA) to assess neurological function；The physiological curvature of cervical vertebra was observed by X-ray.The position of vertebral pedicle screw was assessed by CT 3 d reconstruction.Results All the patients completed the operation successfully，with an average operation time of 132min (110～180 min) and 320 mL(250～450 mL) of average blood loss.All patients were followed up for 12 months to 28 months with an average of 15 months.At the end of the follow-up，the JOA score was improved to (15.19±0.75) from (11.16±2.07) points before surgery，and the difference was statistically significant (t＝－15.03，P＜0.01).The curvature of the cervical vertebra was increased from the preoperative (6.52±7.34) degree to the last follow-up (9.00±11.01) degree，and the difference was statistically significant (t＝2.79，P＜0.01).In this group，the total number of screws was 136，of which the screw perforation rate was 10.3％，all of which perforated the outer wall.There were 3 cases of cerebrospinal fluid leakage and 1 patient with C₅ nerve root paralysis.None of the patients underwent incision infection，nerve injury or the rupture of the portal axis.Conclusion One-stage posterior cervical open-door combined with pedicle screw fixation is a safe and effective method for patients with cervical spinal stenosis and instability.

Key words： cervical spinal stenosis laminoplasty pedicle screw

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Zhou Hongyu 1
	Xu Shuang 2
	Wang Gaoju 2
	et al

Cite this article:

Zhou Hongyu 1,Xu Shuang 2,Wang Gaoju 2, et al. Posterior Cervical Open-door Laminoplasty Combined with Pedicle Screw Fixation for Cervical Spinal Stenosis with Instability[J]. sygkzz, 2018, 24(2): 156-159.

URL:

http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2018/V24/I2/156

［1］White AA 3rd，Panjabi MM.Update on the evaluation of instability of the lower cervical spine［J］，Instr Course Lect，1987(36)：513－520.
［2］Uehara M，Takahashi J，Ogihara N，et al.Cervical pedicle screw fixation combined with laminoplasty for cervical spondylotic myelopathy with instability［J］.Asian Spine J，2012，6(4)：241-248.
［3］王少波，蔡钦林，党耕町，等.单开门颈椎椎管扩大成型术的远期疗效观察［J］.中华骨科杂志，1999，19(9)：519-521.
［4］Ohnari H，Sasai K，Akagi S，et al.Investigation of axial symptoms after cervical laminoplasty。using questionnaire survey［J］.Spine J，2006，6(3)：221-227.
［5］符振宇，郝德强，宫政，等.单开门颈椎椎管成形术减压效果不佳原因分析［J］.中国骨伤，2003，16(8)：480-481.
［6］Takeuchi K，Yokoyama T，Aburakawa S，et al.Anaomic study of the semispinalis cervicis for reattachment during laminoplasty［J］.Clin Orthop Rwlat Res，2005 (436)：126-131.
［7］Steinmetz MP，Resnick DK.Cervical laminoplasty［J］.Spine J，2006，6(6 Suppl)：274S-281S.
［8］Matz PG，Anderson PA，Groff MW，et al.Cervical laminectomy for the treatment of cervical degenerative myelopathy［J］.J Neurosurg Spine，2009，11(2)：142-149.
［9］Suda K，Abumi K，Ito M，et al.Local kyphosis reduces surgical outcomes of expansive opendoor laminoplasty for cervical spondylotic myelopathy［J］.Spine，2003，28(12)：1258-1262.
［10］Kawakami M，Tamaki T，Ando M，et al.Relationships between sagittal alignment of the cervical spine and morphology of the spinal cord and clinical outcomes in patients with cervical spondylotic myelopathy treated with expansive laminoplasty［J］.J Spinal Disord Tech，2002，15(5)：391-397.
［11］Duan Y，Zhang H，Min SX，et al.Posterior cervical fixation following laminectomy：a stress analysis of three techniques［J］.Eur Spine J，2011，20 (9)：1552-1559.
［12］Kothe R，Rüther W，Schneider E，et al.Biomechanical analysis of transpedicular screw fixation in the subaxial cervical spine［J］.Spine，2004，29(17)：1869-1875.
［13］解京明，张漾杰，鲁宁，等.下颈椎经椎弓根螺钉内固定相关解剖学观察［J］.脊柱外科杂志，2006，4(6)：354-358.
［14］SaneUi PC，Tong S，Gonzalez G，et al.Normal variation of vertebral artery On CT angiography and its implications for diagnosis of acquired pathology［J］.Comput Assist Tomogr，2002，26(4)：462-470.
［15］校佰平，徐荣明，冯建翔.颈椎椎弓根与其周围神经结构的解剖学关系［J］.脊柱外科杂志，2003，1(2)：102-104.
［16］Panjabi MM，Shin EK，Chen NC，et al.Interal morphology of human cervical pedicles［J］.Spine，2000，25(10)：1197.
［17］Hiraao T，Hasegawa K，Takahashi H，et al.Structural characteristics of the pedicle and its role in screw stability［J］.Spine，1997，22(21)：2334.