摘要
目的探讨后路单开门椎管扩大椎板成形术用于寰枢椎脱位(AAD)合并下颈椎椎管狭窄(LCSS)的治疗效果。方法回顾分析罗定市人民医院收治的16例AAD合并LCSS患者临床病例资料,所有患者均实施了后路钉棒固定融合术和后路单开门椎管扩大椎板成形术,采用日本骨科学会(JOA)评分、视觉模拟评分(VAS)、寰齿前间隙(ADI)和下颈椎椎管矢状径(LCSD)评估手术治疗效果。结果16例手术均顺利完成,所有患者在术后12个月内均获得寰枢椎骨性融合、下颈椎椎管椎板稳定的效果,未发生“再关门”和寰枢椎再脱位现象。术前、术后1周、术后6个月、末次随访的JOA评分、VAS评分、ADI和LCSD经重复测量方差分析,差异均有统计学意义(P<0.05),表明术后1周、术后6个月、末次随访与术前相比,JOA评分、VAS评分、ADI和LCSD均有所改善。结论在AAD合并LCSS治疗中应用后路钉棒固定融合术和后路单开门椎管扩大椎板成形术效果较好,并发症发生率低。
Objective To explore the effect of posterior single-door laminoplasty for atlantoaxial dislocation(AAD)combined with lower cervical spinal stenosis(LCSS).Methods To retrospectively analyze the clinical case data of 16 patients with AAD and LCSS admitted to our hospital.All patients underwent posterior screw rod fixation and fusion and posterior single-door spinal canal expansion laminoplasty,using the Japanese orthopaedic association(JOA),visual analogue scale/score(VAS),anterior atlantodental interval(ADI),and lower cervical sagittal diameter(LCSD)to evaluate the effect of surgical treatment.Results All 16 operations were successfully completed.All patients achieved atlantoaxial osseous fusion and lower cervical vertebral canal stabilization within 12 months after surgery.There was no“re-closing”and atlantoaxial re-dislocation.The JOA score,VAS score,ADI and LCSD before operation,1 week after operation,6 months after operation,and last follow-up were analyzed by repeated measures variance analysis.The difference was statistically significant(P<0.05),indicating that 1 week after operation,compared with preoperatively,the JOA score,VAS score,ADI and LCSD were improved in the last follow-up 6 months after operation.Conclusion In the treatment of AAD combined with LCSS,the application of posterior screw rod fixation and fusion and posterior single-door spinal canal expansion laminoplasty has good results and low complication rate.
作者
林耀兵
LIN Yaobing(Luoding People’s Hospital,Luoding,Guangdong,527200)
出处
《智慧健康》
2022年第26期102-105,共4页
Smart Healthcare
关键词
后路钉棒固定融合术
单开门椎管扩大椎板成形术
寰枢椎脱位
下颈椎椎管狭窄
Posterior screw rod fixation and fusion
Single-door spinal canal expansion laminoplasty
Atlantoaxial dislocation
Lower cervical spinal stenosis
