Zhang Shi-Min, Zhou Wei, Li Xing, Zhang Lu-Tang, Liu Yu-Zhang, Zhang Zhao-Jie
Department of the First Spinal Surgery, Wangling Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China.
Zhongguo Gu Shang. 2012 Jan;25(1):4-8.
To evaluate the clinical effects of titanium miniplate in cervical expansive open-door laminoplasty in treating cervical spondylosis.
From February 2009 to April 2011, 16 patients underwent expansive open-door laminoplasty by titanium miniplate fixation were classified as group A; 18 patients with conventional unilaterally open-door laminoplasty from March 2007 to January 2009 were served as control (group B). The operative time, blood loss during the operations, JOA score of the 6 months after operation, the incidence of axial symptom, curvature of cervical vertebrae were compared respectively between the two groups.
Operative time, blood loss, improvement rate of JOA in group A were respectively (122.0 +/- 26.8) min, (153.0 +/- 46.7) ml, (59.4 +/- 11.6)%; and in group B were (119.0 +/- 28.6) min, (151.0 +/- 50.4) ml, (58.7 +/- 12.7)%. Those showed no significant difference between two groups (P > 0.05). Three cases (18.75%) occurred obviously axial symptom in group A and six cases (33.33%) occurred in group B, there was significant difference in the incidence of axial symptom between two groups (P < 0.01). Preoperative and postoperative curvature of cervical vertebrae in group A was (17.9 +/- 5.2) degrees and (18.2 +/- 4.8) degrees, without significant difference; in group B, postoperative curvature of cervical vertebrae decreased obviously than the preoperative [(16.3 +/- 5.9) degrees vs (18.1 +/- 6.3) degrees] (P < 0.05).
Both surgical protocols are effective on preventing reclose of opened laminae, moreover the modified laminoplasty is advanced on reducing the occurrence of axial symptoms and loss of cervical curvature.
评估钛微型钢板在颈椎扩大开门椎板成形术中治疗颈椎病的临床效果。
将2009年2月至2011年4月行钛微型钢板固定扩大开门椎板成形术的16例患者归为A组；将2007年3月至2009年1月行传统单侧开门椎板成形术的18例患者作为对照组（B组）。分别比较两组的手术时间、术中出血量、术后6个月的JOA评分、轴性症状发生率、颈椎曲度。
A组手术时间、出血量、JOA改善率分别为（122.0±26.8）分钟、（153.0±46.7）毫升、（59.4±11.6）%；B组分别为（119.0±28.6）分钟、（151.0±50.4）毫升、（58.7±12.7）%。两组比较差异无统计学意义（P>0.05）。A组有3例（18.75%）出现明显轴性症状，B组有6例（33.33%）出现，两组轴性症状发生率比较差异有统计学意义（P<0.01）。A组术前、术后颈椎曲度分别为（17.9±5.2）度和（18.2±4.8）度，差异无统计学意义；B组术后颈椎曲度较术前明显减小[（16.3±5.9）度对（18.1±6.3）度]（P<0.05）。
两种手术方案在防止开门椎板再闭合方面均有效，而且改良椎板成形术在减少轴性症状的发生和颈椎曲度丢失方面更具优势。
