颈后路单开门椎管成形术中门轴断裂相关原因分析及对临床疗效的影响

doi:10.3969/j.issn.1006-6233.2020.12.026

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Abstract Objective: To observe the causes of hinge fracture during laminoplasty and its effect on clinical efficacy. Methods: A total of 214 patients with cervical spondylotic myelopathy who underwent laminoplasty in our hospital from May 2014 to October 2018 were enrolled, and they were divided into fracture group (58 cases) and intact group (156 cases) according to whether the hinge was fractured. The neurological function (JOA score), cervical curvature index (CCI), axial symptoms (VAS score) and factors associated with hinge fracture were observed and compared. Results: There was no significant difference in the hinge position between the 2 groups (P>0.05). The laminae opening angle of the fractured group were significantly greater than that of the intact group, while the bone mineral density was significantly lower than that of the intact group (P<0.05). The postoperative JOA score was significantly increased in both groups (P<0.05), and there was no statistical difference in neurological function recovery rate between the 2 groups (P>0.05). The CCI was well maintained in both groups (P>0.05), and there was no significant difference between groups (P>0.05). The VAS scores of the two groups showed a significant increase when compared with the preoperative level (P<0.05), and the scores in fractured group was higher than the intact group at different time points (P<0.05). Conclusions: The hinge fracture is associated with the decrease of bone mineral density and excessive opening angle. It will aggravate the axial symptoms, but will not affect the recovery of neurological function and the maintenance of cervical curvature.

Key words： Cervical spondylotic myelopathy Laminoplasty Hinge fracture Cervical curvature Axial symptoms

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.12.026 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I12/2044

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