Lin Hua-Jie, Xu Rong-Ming, Li Qi-Yun, Liu Guan-Yi, Ma Wei-Hu, Sun Shao-Hua
Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China.
Zhongguo Gu Shang. 2012 Sep;25(9):711-4.
To investigate the clinical outcomes of lower cervical spinous process laminar screw technique in open door laminoplasty.
From February 2005 to June 2010,12 patients with cervical myelopathy were treated with open door laminoplasty by lower cervical spinous process laminar screw technique. There was intervertebral disc herniation with degenerative stenosis in 5 patients, ossification of posterior longitudinal ligament with osteophyte in 6 patients, cervical traumatic instability with spinal cord injuries in 1 patient. Nerve function, complications, and the cervical canal to body ratio (CBR), range of motion (ROM) and the anteroposterior serial alignment were observed by Japanese Orthopedic Association (JOA) score, X-ray, CT and MRI.
The surgical time was from 1.5 to 2 h with an average of 110 min; blood loss during operation was from 450 to 800 ml with an average of 580 ml. Postoperative complication occurred in 1 case with upper limb pain and 1 case with cerebrospinal fluid leakage. All patients were followed up from 1 to 2 years with an average of 21.8 months. JOA score improved from preoperative 9.5 +/- 1.8 to postoperative 13.6 +/- 2.4 (P < 0.01). X-ray, CT, MRI showed CBR increased obviously (P < 0.01); ROM on flexion-extension and cervical lordosis decreased respectively from (40.0 +/- 10.0) degrees and (65.0 +/- 12.0)% before operation to (15.0 +/- 5.0) degrees and (42.0 +/- 8.0) % at the final follow-up (P < 0.01).
Lower cervical spinous process laminar screw technique in open door laminoplasty for cervical syndrome is safe and can obtain satisfactory effects, has strong internal fixation and reduce the risk of re-closure.
探讨下颈椎棘突椎板螺钉技术在开门式椎板成形术中的临床疗效。
2005年2月至2010年6月，12例脊髓型颈椎病患者采用下颈椎棘突椎板螺钉技术行开门式椎板成形术。其中5例为椎间盘突出伴退行性狭窄，6例为后纵韧带骨化伴骨赘形成，1例为颈椎创伤性不稳伴脊髓损伤。通过日本骨科协会（JOA）评分、X线、CT及MRI观察神经功能、并发症、椎管与椎体比值（CBR）、活动度（ROM）及矢状位序列。
手术时间为1.5～2小时，平均110分钟；术中出血量为450～800毫升，平均580毫升。术后出现1例上肢疼痛并发症和1例脑脊液漏并发症。所有患者随访1～2年，平均21.8个月。JOA评分由术前的9.5±1.8提高至术后的13.6±2.4（P<0.01）。X线、CT、MRI显示CBR明显增加（P<0.01）；屈伸活动度及颈椎前凸分别由术前的（40.0±10.0）°和（65.0±12.0）%降至末次随访时的（15.0±5.0）°和（42.0±8.0）%（P<0.01）。
下颈椎棘突椎板螺钉技术用于颈椎病开门式椎板成形术安全，效果满意，内固定牢固，降低了再关门风险。
