Clinical Observation on Pedicle Screw Fixation Combined with Improved Expansive Open-door Laminoplasty in Treatment of Chronic Compressive Cervical Myelopathy
QIN XiangYing, LIAN Xuehui, LEI Gao, et al
Yunnan Zhong De Department of Orthopedics Hospital, Yunnan Kunming 650200, China
摘要目的:分析椎弓根固定联合改良单开门椎管扩大成形术治疗慢性压迫性颈脊髓病的临床疗效。方法:选取2015年5月至2017年2月就诊于我院脊柱外科的80例慢性压迫性颈脊髓病患者作为研究对象,随机将患者分为对照组40例,采用单独改良单开门椎管扩大成形术治疗;研究组40例,采用椎弓根固定联合改良单开门椎管扩大成形术治疗。比较两组患者术后3个月神经功能、颈椎曲度、颈椎活动度变化及并发症发生率。结果:术后3个月两组患者JOA评分(Japanese Orthopaedic Association Scores)均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);术后3个月两组患者的颈椎曲度、颈椎活动度均低于术前,但研究组患者颈椎曲度、颈椎活动度高于对照组,差异有统计学意义(P<0.05);术后研究组患者轴性症状发生率低于对照组,差异有统计学意义(P<0.05);两组患者新增颈椎不稳、颈后肌无力、感染发生率比较,差异无统计学意义(P>0.05)。结论:采用椎弓根固定联合改良单开门椎管扩大成形术治疗慢性压迫性颈脊髓病疗效显著,能有效改善患者神经功能,减少颈椎曲度、颈椎活动度丢失,降低术后并发症发生风险。
Abstract：Objective: To investigate the clinical efficacy of pedicle screw fixation combined with improved expansive open-door laminoplasty in treatment of chronic compressive cervical myelopathy. Methods: 80 patients with chronic compressive cervical myelopathy treated in our hospital from May 2015 to February 2017 were selected as research object. According to random number table, patients were divided into control group (n=40) which purely took improved expansive open-door laminoplasty; research group (n=40) which took pedicle screw fixation combined with improved expansive open-door laminoplasty. The nerve function, cervical curvature, range of motion (ROM) changes and incidence of complications after surgery for 3 months in two groups were compared. Results:After surgery for 3 months, the Japanese orthopaedic association (JOA) scores of two groups were higher than before surgery, and research group was higher than control group (P<0.05); After surgery for 3 months, the cervical curvature, ROM of two groups were lower than before surgery, but research group was higher than control group (P<0.05); After surgery, the incidence of axial symptoms of research group was lower than that of control group (P<0.05); There was no statistical difference in the incidence of added cervical instability, posterior neck myasthenia, infection compared between the two groups (P>0.05).Conclusion: Pedicle screw fixation combined with improved expansive open-door laminoplasty for treating chronic compressive cervical myelopathy has significant efficacy, which can effectively improve nerve function, reduce the loss of cervical curvature and ROM, decrease risks of postoperative complications.
2018, Vol. 24 
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