关键词: 脊髓型颈椎病,  , 颈椎单开门微型钛板固定成形术,  , 椎板开门角度,  , 轴性症状

Abstract:

Objective To investigate the effects of different lamina door opening angles on postoperative axial symptoms of cervical single⁃door micro titanium plate laminoplasty. Methods We selected 107 patients with multi⁃segment cervical spondylotic myelopathy treated with posterior cervical single⁃door micro titanium plate lami⁃ noplasty in our hospital from July 2016 to July 2019，including 68 males and 39 females. Based on the lamina door opening angles measured on the CT images one week after the operation，the patients were divided into 3 groups： group A（< 30°，n = 33）；group B（30°～45°，n = 43）；group C（> 45°，n = 31）. The VASand JOAwereused to evaluate the degree of postoperative axial pain and the nerve recovery，respectively. Results During the postopera⁃ tive follow⁃up，the VAS scores of the patients in group C were significantly higher than the other two groups at dif⁃ ferent periods（P < 0.05）. There was no significant difference in the JOA improvement rate among the three groups （P > 0.05），but the neurological functions of the three groups were significantlyimproved as compared with their preoperative functions（P < 0.05）. C5 nerve root palsy occurred in 4 cases（3.7%）after operation，and its incidence was not significantlydifferent across the three groups statistically（P > 0.05）. There were no significant differences in age，course of disease，and operation time，intraoperative blood loss，C2⁃ C7 Cobb angle and cervical spine range of motion among the three groups（P > 0.05）. Conclusion Posterior cervical single⁃door spinal canalplasty can achieve good spinal cord decompression and improvement of nerve function，but it may cause significant loss of cervical spine mobility and curvature. Noticeably，the larger the opening angle is，the severe the postoperative axial pain