中国骨伤2025，Vol.38Issue(2)：170-175,6.DOI:10.12200/j.issn.1003-0034.20230242
单开门椎板成形联合单侧侧块螺钉治疗颈椎后纵韧带骨化合并颈椎不稳
Expansive open-door laminoplasty combined with unilateral lateral mass screw in the treatment of ossification of pos-terior longitudinal ligament with cervical instability
周洋 1李驰 1戴王颖 1滕红林 1朱旻宇 1王宇 1王靖1
作者信息
- 1. 温州医科大学附属第一医院脊柱外科,浙江 温州 325000
- 折叠
摘要
Abstract
Objective To investigate the effect of expansive open-door laminoplasty combined with single lateral mass screw fixation on the posterior longitudinal ligament ossification and cervical instability and its effect on sagittal balance.Methods A retrospective analysis of 65 patients with the posterior longitudinal ligament with cervical instability from May 2012 to July 2018 was conducted.The patients were divided into two groups according to the surgical method.Thirty-four patients were treated with open-door laminoplasty including 19 males and 15 females,aged 49 to 60 years old with an average age of(54.4±4.77)years old;symptoms lasted 8 to 39 months with an average of(21.0±8.2)months.Thirty-one patients were treated with single-door laminoplasty combined with single mass screw fixation including 17 males and 14 females,aged 50 to 59 years old with an average age of(55.4±3.2)years;symptoms lasted 7 to 48 months with an average of(23.7±13.1)months.General information of the two groups,including operation time,intraoperative blood loss,and postoperative complications was record-ed.Sagittal vertical axis(SVA),C0-C2 and C2-C7 cobb angle were measured by X-ray before operation and at the last follow-up.Clinical efficacy was evaluated using the Japanese Orthopaedic Association(JOA)score.Results Surgery was successful in all patients.The operation time(109±15)min in the single-door laminoplasty combined with lateral mass screw fixation group was longer than that in the single-door group(128±16)min(P＜0.05).There was no significant difference in intraoperative blood loss,postoperative axial symptoms and follow-up time between two groups(P＞0.05).At the latest follow-up,both groups showed significant improvement in the motor and sensory components of the JOA score and the total JOA score compared to pre-surgery(P＜0.05)and no significant change in bladder function score(P＞0.05).There was no significant difference between two groups(P＞0.05).At the latest follow-up,the C0-C2 Cobb angle increased in both groups compared to preoperative and more the single-door laminoplasty group(P＜0.05).The angle of the C2-C7 Cobb angle decreased in both groups,and the reduction was greater in the single-door laminoplasty combined with lateral mass screw fixation group(P＜0.05).There was a significant in-crease in C2-C7 SVA in the single-door laminoplasty group(P＜0.05)and no significant change the single-door laminoplasty combined with lateral screw fixation group(P＞0.05).Conclusion Posterior cervical laminoplasty with unilateral lateral mass screw fixation combined with single-door vertebral plate shaping surgery improves the neurological function and quality of life in patients with cervical spondylotic myelopathy complicated by ossification of the posterior longitudinal ligament and cervical instability.Compared with single-door vertebral plate shaping surgery,postoperative cervical lordosis and forward-tilt can be improved.关键词
后纵韧带骨化/单开门椎板成形术/侧块螺钉/矢状位平衡Key words
Ossification of the posterior longitudinal ligament/Expansive open-door laminoplasty/Lateral msss screw/Sagittal balance分类
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周洋,李驰,戴王颖,滕红林,朱旻宇,王宇,王靖..单开门椎板成形联合单侧侧块螺钉治疗颈椎后纵韧带骨化合并颈椎不稳[J].中国骨伤,2025,38(2):170-175,6.
