针对单开门椎管扩大成形术中椎板门轴侧断裂伴移位的问题,对不同门轴处理方式的术后疗效进行研究.通过回顾性分析,将2013年5月—2018年9月在邯郸市中心医院接受单开门椎管成形钛板固定术治疗的319例脊髓型颈椎病患者纳入研究中,其中有63例患者术中发生门轴断裂伴椎板移位,根据处理方式将其分为两组:重建组(35例),对椎板进行叠瓦状重建及钛板固定治疗;切除组(28例),将断裂并移位的椎板切除.记录并比较两组患者术中的相关指标,观察患者神经功能(JOA评分)、颈椎曲度指数(cervical curvature index,CCI)、颈后肌群横截面积变化及轴性症状的发生情况.结果表明:在手术时间及术出血量上,两组比较无显著统计学差异(P>0.05).术后两组的颈后肌群横截面积较术前均有明显减小(P<0.05),但重建组横截面积减小程度明显低于切除组(P<0.05).重建组术后CCI获得较好维持(P>0.05),切除组的CCI较术前出现明显丢失(P<0.05);至末次随访时,组间比较有显著统计学差异(P<0.05).两组患者JOA评分均有显著升高(P<0.05),组间比较无显著统计学差异(P>0.05).术后重建组有8.6％的患者出现轴性症状(3/35),切除组为21.3％(6/28),具有显著统计学差异(P<0.05).术后3个月时,重建组81.6％(31/38)的断裂门轴获得骨性融合,至术后6个月时,有94.7％(36/38)的断裂门轴获得骨性融合.可见,对于门轴断裂伴椎板移位的患者,采用叠瓦状椎板重建联合钛板固定及切除椎板均不会影响术后神经功能的恢复,但椎板重建更有利于颈椎曲度的维持并减轻颈后肌群的萎缩,从而降低轴性症状的发生.

颈椎棘突是颈后肌群重要的附着点,在全椎板减压术或单开门椎管成形术中极易被破坏.为明确重建伸肌附着点及保留C7棘突开槽式减压在治疗脊髓性颈椎病的临床疗效,分析了2017年1月—2018年7月81例多节段脊髓型颈椎病患者在邯郸市中心医院接受单开门椎管扩大成形术治疗的情况,其中70例获得完整临床随访.根据手术方法将其分为两组:观察组(37例),单开门术中采用伸肌附着点重建和保留C7棘突开槽式减压治疗;对照组(33例),行常规单开门椎管成形钛板固定术治疗.记录手术时间及术中出血量,观察术后患者神经功能改善、颈椎曲度指数(cervical curvature index,CCI)改变、颈后肌群横截面积变化及轴性症状(axial symptoms,AS)的发生情况.结果表明:观察组在手术时间及术中出血量上明显高于对照组(P<0.05);在椎板开门角度及脊髓漂移距离上,两组比较无显著统计学差异(P>0.05);术后两组患者的JOA评分较术前有显著升高(P<0.05),两组在神经功能恢复率上无显著统计学差异(P>0.05).观察组在CCI及颈后肌群横截面积上与术前比较无显著统计学差异(P>0.05),对照组的上述数值较术前明显减小(P<0.05).观察组轴性症状发生率为8.1％(3/37),对照组为21.2％(7/33),具有显著统计学差异(P<0.05).可见,在单开门椎管成形术中,重建伸肌附着点及保留C7棘突开槽式减压会增加手术时间,但术式的改进可以更好地维持颈椎曲度,减轻颈后肌群萎缩并降低术后轴性症状的发生.

目的:探讨颈椎侧块螺钉固定术后颈椎曲度大小与与临床疗效的关系.方法:2018年02月～2019年10月纳入65例脊髓型颈椎病患者进行研究,均采用全椎板减压侧块螺钉固定术,术后测量颈椎曲度,根据大小将其分为两组:A组(29例),颈椎曲度正常(7mm≤弧弦距≤17mm);B组(36例),颈椎曲度减小(00.05).A组轴性症状VAS评分显著高于B组(P<0.05).A组有3例(7.9％)患者发生C5神经麻痹,B组有4例(12.1％),两组在C5神经麻痹发生率上无显著统计学差异(P>0.05).结论:侧块螺钉固定术后颈椎曲度变小临床常见,该现象不会影响神经功能的恢复及C5神经麻痹的高发,但会加重患者的轴性症状.

目的:探讨椎板分区切除法脊髓减压内固定术在治疗胸椎黄韧带骨化症(thoracic ossification of the ligamentum flavum,T-OLF)的疗效性及安全性.方法:回顾性分析58例T-OLF病人的临床资料,根据手术方法将其分为:A组(25例),根据黄韧带的解剖学特点及与椎板的毗邻关系,在椎板后方进行区域划分后,采用椎板分区减压、逐节切除、脊髓减压内固定术治疗;B组(21例),采用椎板分层薄化法减压内固定术治疗.记录2组手术时间、出血量及并发症发生情况,观察术后病人神经功能恢复及局部后凸角变化情况.结果:2组手术时间和术中出血量差异均无统计学意义(P>0.05).2组术后JOA评分均较术前有明显升高(P<0.05));A组神经功能改善率(72.2±14.8)％,B组为(73.1±15.2)％,差异无统计学意义(P>0.05).2组术后局部Cobb角均较术前有明显改善(P<0.01),不同时间点组间比较差异均无统计学意义(P>0.05).A组病人脑脊液漏发生率12.00％与B组的23.80％差异有统计学意义(P<0.05).结论:椎板分区切除法脊髓减压内固定可减少椎管内侵袭性操作,硬膜撕裂的发生率低,安全性相对高,内固定植入有利于术后胸椎稳定性更好维持.

Objective:To investigate the relationship between cervical curvature (CC) and spinal drift distance after laminectomy with lateral mass screw fixation and the influence on the operative effect.Methods:From October 2016 to December 2017, a total of 85 patients with cervical spondylotic myelopathy (CSM) underwent laminectomy with lateral mass screw fixation in handan central hospital, and 78 patients were followed up completely.After the operation, according to the Harrison method, they were divided into 2 groups(Group A (43 cases, 0°≤CC≤16.5°); Group B (35 cases, CC>16.5°)). The spinal drift distance, nerve recovery, axial symptoms and C5 palsy in the groups were recorded and analyzed.Results:The CC was 8.5°±3.8° in group A and 19.6°±3.0° in group B ( t=14.071, P=0.000). The laminectomy width in group A was (22.1±1.7) mm, in group B was (21.8±1.5) mm, the difference between the two groups was not statistically significant ( P>0.05). The distance of spinal cord backward movement was (1.7±0.4) mm in group A and (3.2±0.7) mm in group B. There was significant difference between the two groups ( t=11.879, P<0.001). At the end of one year, the improvement rates of nerve function in the two groups were (63.3±13.1)% and (65.1±13.9)% respectively, there was no significant difference between the two groups ( t=0.587, P=0.559). The VAS score of group A was (5.2±1.3) at one week and (3.5±0.6) at one month after operation, and that of group B was (3.8±0.8) and (2.4±0.4) respectively.There were statistically significant differences between groups at different time points ( t=5.567, P<0.001; t=9.289, P<0.001). The incidence of C5 paralysis was 7.0% (3/43) in group A and 11.4% (4/35) in group B. There was no significant difference between the two groups ( P>0.05). Conclusion:The greater the curvature of cervical spine is, the more fully the spinal cord moves backward.The loss of curvature of cervical spine is related to the occurrence of axial symptoms.The curvature of cervical spine is not related to the recovery of nerve function and the occurrence of C5 nerve paralysis.

目的:观察单开门微型钛板固定联合保留C7棘突开槽式椎板减压及颈后伸肌附着点重建术在治疗脊髓型颈椎病(CSM)的临床效果.方法:回顾性分析32例接受手术治疗的多节段CSM(M-CSM)患者,采用单开门微型钛板固定联合保留C7棘突开槽式椎板减压及颈后伸肌附着点重建术治疗,观察患者手术时间、术中出血量及椎板开门角度,术后神经功能改善、颈椎曲度指数(CCI)、颈后肌群横截面积变化及轴性症状(AS)的发生情况,以日本矫形外科协会(JOA)评分评估患者手术前后神经的功能状态.结果:患者的平均手术时间(131.7±26.9)min,术中出血量(313.6±51.2)ml,椎板开门角度(51.90±8.30)°;所有患者均获得超过1年的临床随访,平均随访时间(21.2±8.3)个月;在JOA评分中,术前(7.9±2.4)分,术后3个月时(12.7±3.3)分,末次随访时(13.6±3.7)分,手术前后比较差异有显著统计学意义(F=29.711,P<0.05);神经功能改善率(62.6±11.2)％.CCI术前为(16.4±3.9)％,术后3个月时为(13.7±3.2)％,末次随访时减小为(14.9±3.6)％,其差异无统计学意义.颈后肌群横截面积由术前的(35.9±7.3)cm2减小为术后1年时的(32.5±6.7)cm2,差异亦无统计学意义.轴性症状发生率为12.5％.结论:对于累及C7水平的M-CSM,采用单开门微型钛板固定联合保留C7棘突开槽式椎板减压及颈后伸肌附着点重建,可以显著促进神经功能恢复,减轻颈后肌群萎缩,显著降低术后轴性症状的发生.

目的:观察全椎板减压侧块螺钉固定术与单开门钛板固定术治疗脊髓型颈椎病术后在神经功能、轴性症状及C5神经根神经麻痹上的差异.方法:选取在医院接受颈后路手术治疗的92例脊髓型颈椎病临床资料符合标准的患者,根据接受手术方式的不同将其分为观察组(45例)和对照组(47例),观察组采用全椎板减压侧块螺钉固定术治疗,对照组采用单开门椎管扩大成形钛板固定术治疗.术后采用日本骨科协会(JOA)脊髓损害评分表(17分法)评估手术前后神经恢复情况,观察两组患者颈椎活动度(ROM)、颈椎曲度指数(CCI)、脊髓漂移距离、轴性症状及C5神经根麻痹发生情况.结果:观察组患者的手术时间、术中出血量均高于对照组,差异有统计学意义(t=4.951,t=7.461;P<0.05);观察组患者椎板切除宽度和脊髓漂移距离分别为(17.2±2.8)mm和(2.4±0.6)mm,对照组分别为(22.5±3.2)mm和(2.6±0.7)mm,两组椎板切除宽度比较差异有统计学意义(t=8.439,P<0.05),脊髓漂移距离无统计学差异.观察组和对照组患者术后JOA评分较术前均显著增高,其差异有统计学意义(F=50.734,F=52.638;P<0.05).观察组患者术后较术前CCI有显著改善,其差异有统计学意义(F=15.360,P<0.05);对照组CCI则出现显著丢失(F=12.962,P<0.05).观察组患者ROM丢失程度显著高于对照组,其差异有统计学意义(t=10.549,P<0.05).观察组C5神经根麻痹发生率为8.9％,对照组发生率为6.4％,两组比较差异无统计学差异.结论:侧块螺钉在恢复颈椎曲度与微型钛板相比具有优势,但术后颈椎活动度丢失较多,故适当缩小椎板切除宽度与单开门均可限制脊髓向后漂移,可降低C5神经根麻痹及轴性症状的发生.

目的 观察脊髓型颈椎病患者全椎板减压侧块螺钉固定术后颈椎曲度的变化,并探讨其对临床疗效的影响.方法 行全椎板减压侧块螺钉固定术治疗的脊髓型颈椎病患者76例,采用Bordon法测量术后颈椎曲度并将其分为A组(0<颈曲值<7 mm)41例、B组(7 mm≤颈曲值≤17 mm)35例.观察两组椎板切除宽度、脊髓后移距离、神经功能恢复情况(采用JOA评分评价)、轴性症状及C5神经麻痹发生情况.结果 A组椎板切除宽度为(19.9±1.5)mm,B组为(20.6±1.7)mm,两组比较,P>0.05;A组脊髓后移距离为(1.8±0.4)mm,B组为(2.7±0.6)mm,两组比较,t=7.792,P<0.01.两组术后3个月及末次随访时JOA评分均较术前升高(P均<0.05);但不同时间点组间比较,P均>0.05.A组神经功能恢复率为63.2％ ±12.8％、B组为64.5％ ±13.7％,两组比较,P>0.05.术后1个月时,A组轴性症状严重程度高于B组(Z=-2.384,P=0.017).两组C5神经麻痹率比较,χ2=0.011,P=0.918.结论 脊髓型颈椎病患者全椎板减压侧块螺钉固定术后超过一半的患者出现颈椎曲度变小,颈椎曲度变小可促使脊髓后移距离变短、轴性症状严重程度加重,而与神经功能的恢复及C5神经麻痹无明显关联.

目的 比较经皮椎体成形术(PVP)治疗年龄＜80岁与年龄≥80岁老年骨质疏松性椎体压缩骨折临床疗效.方法 回顾性分析自2015-10-2018-09采用PVP治疗的100例老年骨质疏松性椎体压缩骨折,年龄＜80岁者81例(老年组),年龄≥80岁者19例(高龄组).比较2组手术时间、骨水泥注入量、并发症情况、术后7d及6个月疼痛VAS评分及ADL评分.结果 2组手术时间、骨水泥注入体积比较差异无统计学意义(P＞0.05).高龄组并发症情况较老年组优,差异有统计学意义(P＜0.05).2组术后7天、术后6个月疼痛VAS评分、ADL评分比较差异无统计学意义(P＞0.05).结论 PVP可以有效缓解80岁及以上的骨质疏松性椎体压缩骨折疼痛,术后恢复满意.

观察颈椎后路限制性椎板减压术后颈椎曲度大小与颈髓后移距离的关系及对手术疗效的影响.2016年1月至2017年12月,有87例颈椎曲度正常的脊髓型颈椎病患者在邯郸市中心医院接受限制性椎板切除术治疗,其中有74例获得完整的临床随访.术后根据harrison方法测量颈椎曲度并将其分为:A组,颈椎曲度变减小(0°≤颈椎角≤16.5°);B组,颈椎曲度正常(颈椎角>16.5°).术后观察两组患者神经功能改善情况、脊髓后移距离、颈椎活动度(range of motion,ROM)、轴性症状严重程度及C5神经麻痹发生情况.在平均23.8个月的临床随访中,36例患者(A组)的颈椎曲度变小(48.6％),平均颈椎角为9.7°±5.3°;38例患者(B组)颈椎曲度维持正常(51.4％),颈椎角为18.7°±4.6°,两组颈椎曲度比较具有显著统计学差异(P<0.05);A组椎板切除宽度为(18.5±2.1)mm,B组为(17.9±1.8)mm,差异无统计学意义(P>0.05);A组脊髓后移距离为(1.8±0.5)mm,B组为(2.6±0.8)mm,具有显著统计学意义(P<0.05).术后两组患者的ROM较术前无明显减小(P>0.05),日本矫形外科协会(Japanese Orthopaedic Association,JOA)评分均较术前有明显升高(P<0.05),组间比较无显著统计学差异(P>0.05);A组轴性症状严重程度明显重于B组(P<0.05);A组有3例(8.3％)患者发生C5神经麻痹,B组有4例(10.5％),两组比较无统计学差异(P>0.05).以上结果表明,限制性椎板切除术后仍有近半数的患者出现颈椎曲度丢失,颈椎曲度减小使得脊髓后移距离缩短并增加轴性症状的严重程度,而颈椎曲度与神经恢复效果及C5神经麻痹无明显关联.

目的:探讨麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证的临床疗效以及对血流动力学和血清疼痛介质的影响.方法:筛选2016年7月至2018年7月在天津市宁河区医院诊治的肩周炎患者共有120例,按随机数字表法将患者分为对照组和观察组,每组60例.对照组患者接受关节松动术治疗,每日1次,口服塞来昔布胶囊.观察组在接受关节松动术治疗的基础采取麻桂温经汤加味内服,1剂/d,2次/d.两组患者连续治疗4周后,比较患者的主观疼痛程度McGill疼痛问卷(SF-MPQ)评分,肩关节活动度血流动力学变化,以及血清前列腺素E2(PGE2),P物质(SP),五羟色胺(5-HT)水平和临床疗效.结果:与本组治疗前比较,治疗4周后两组患者的视觉疼痛评分(VAS),现在疼痛状况(PPI),疼痛评级指数(PRI)评分明显降低,且观察组显著低于对照组(P＜0.01),肩关节活动范围明显高于对照组(P＜0.01);与本组治疗前比较,治疗4周后两组患者的红细胞沉降率(ESR),纤维蛋白原(Fb),全血黏度以及血清PGE2,SP,5-HT水平显著降低(P＜0.01),且观察组显著优于对照组(P＜0.01);观察组临床总有效率为96.61％ (57/59),明显高于对照组的82.76％ (48/58)(x2=4.685,P＜0.05).结论:麻桂温经汤加味联合关节松动术治疗肩周炎血虚寒凝证,能有效改善患者的疼痛、肩关节活动度,提高疗效,改善患者的血流动力学和下调疼痛介质PGE2,SP,5-HT水平可能与其疗效有关.

目的 观察颈后路单开门微型钛板固定联合伸肌附着点重建在治疗累及C2节段脊髓型颈椎病的临床疗效.方法 回顾性分析2014年3月至2017年1月接受手术的累及C2节段脊髓型颈椎病患者46例的临床资料,根据手术方式将其分为两组,对照组(n=21)采用传统单开门椎管扩大成形钛板固定术,观察组(n=25)采用单开门椎管扩大成形钛板固定+伸肌群附着点重建术治疗.术后观察患者的日本骨科协会(JOA)脊髓损害评分、颈椎活动度、颈椎曲度、颈后肌群截面积和轴性症状发生情况.结果 两组手术时间和术中出血量无显著性差异(t<0.863,P>0.05).两组术后JOA评分均显著升高(F>24.961,P<0.001),组间无显著性差异(t<0.282,P>0.05).两组术后颈椎总活动度无明显变化(F<0.931,P>0.05).对照组术后颈椎中立位曲度明显减小(F=8.241,P<0.01),观察组则无明显改变(F=2.705,P>0.05).对照组术后颈后肌群截面积减小(t=2.678,P<0.05),观察组术后无明显改变(t=0.854,P>0.05).观察组轴性症状发生率低于对照组(Z=-2.192,P<0.05).结论 椎管成形术可解除C2节段脊髓压迫,促进神经功能的恢复;结合伸肌附着点重建可更好维持颈椎曲度,减轻颈后肌群萎缩,降低轴性症状发生.

Objective To observe the effect of different fixation methods on cervical curvature and axial symptoms in posterior cervical single?door surgery??Methods From September 2014 to February 2016, 112 patients with multi?segment cervical spondylotic myelopathy underwent surgical treatment in Handan Central Hospital of Hebei Province??According to the lamina fixation methods,they were divided into groups A,B and C??There were 35 cases in group A,using suture suspension method to fix lamina; 34 cases in group B,using anchor suspension to fix lamina;and 43 cases in group C,using mini?titanium plate to fix lamina The operation time,intraoperative blood loss,laminae open angle,spinal drift distance,postoperative neurological recovery,cervical curvature index ( CCI ) and occurrence of axonal symptoms were compared in each group??Results All patients underwent surgery successfully??There were no significant differences in operation time,intraoperative blood loss,laminae open angle and spinal drift distance between the 3 groups (all P＞0??05)??The JOA score of group A was (7??9± 2??2) preoperatively,(9??3± 2??8) at 3 months after surgery,and (13??9±3??4) at the final follow?up??In Group B was (7??7±2??0) preoperatively,(9??1±2??7) at 3 months after surgery,and (13??6±3??7) at the final follow?up??In Group C was (7??8±2??1),( 9??0±2??6) and (13??8 ± 3??5 ), respectively, there were significant differences before and after operation ( Fintra?grouP＝7??271, Pintra?grouP ＜ 0??001; Finter?grouP ＝ 11??372, Pinter?grouP ＜ 0??001; Finteraction ＝ 9??831, Pinteraction＜0??001)??The CCI of group A was ( 22??7± 5??6)% preoperatively,(20??5± 4??4)% at 3 months after surgery,and (16??6± 3??0)% at the final follow?up??The CCI of group B was ( 21??4 ± 5??2)%,( 19??7 ±4??1)% and (17??8±2??9)% respectively??The CCI of group C was ( 21??1 ± 5??0)%,( 20??8 ± 4??6)% and (19??8 ± 4??0)% respectively??There were significant differences between group A and group B in the last follow?up and the three months before and after operation??( all P＜0??05),there was no significant difference between groups C at different time points ( P＞0??05)??According to the visual analogue scoring system,the distribution of axial symptoms in group C was significantly better than that in group A and group B ( Z＝6??678;P＝0??035)??Conclusion Posterior single?door mini?titanium plate fixation can not only improve nerve function,but also prevent cervical curvature loss and reduce the occurrence of axonal symptoms??

目的:开展本次研究是为了实际探究神经根型颈椎病患者在临床护理过程中有效运用循证护理的效果.方法:挑取2018年5月-2019年5月作为本次研究的开展时间段,研究样本主要采集自我院接收治疗的神经根型颈椎病患者,具体样本数量为110例,患者实施分组时所运用的依据为护理方法差异,患者选择运用循证护理作为循证组,患者选择运用一般护理作为对照组.结果:循证组患者的护理效果有效率与满意度评分高于对照组,P<0.05.结论:临床神经根型颈椎病患者在临床护理过程中充分运用循证护理,可获取较好护理效果,使得患者可以满意于临床护理服务.

Objective To observe the effect of limited laminectomy combined with foraminal stenosis decompression on preventing C5nerve root palsy and improving neurological function. Methods From March,2014 to May,2016,69 patients with multi-segment cervical spondylotic myelopathy underwent surgical treatment in our hospital were included.Thirty-eight patients(group A)were treated with limited lami-nectomy combined with foraminal stenosis decompression and internal fixation,and 31 patients(group B)under-went routine laminectomy and internal fixation.The postoperative neurological recovery rate,cervical curvature index(CCI)and C5palsy rate were recorded and analyzed. Results No spinal cord and nerve injury occurred during the operation.The width of laminectomy was(16.8±2.1)mm in group A,and was significantly less than(21.7±2.5)mm in group B(t=8.849,P<0.001).There was no significant difference in operation time and intraoperative blood loss between two groups(t<0.439,P>0.05).The Japanese Orthopaedic Association (JOA) score increased continuously after surgery in both groups (F>42.996, P<0.05), and no significant difference was found between them at each time point(t<1.021,P>0.05).The cervical curva-ture index improved after surgery(F>86.379,P<0.05),and no significant difference was found between them at each time point(t<0.943,P>0.05).The spinal cord drift distance was(3.6±0.7)mm in group A,and ws signifi-cantly shorter than(2.5±0.5)mm in group B(t=7.602,P<0.001).There was no significantly difference in the neu-rological recovery rate between two groups(t=0.724,P=0.471).The C5palsy rate was lower in group A(5.2%,2/38)than in group B(22.5%,7/31)(χ2=4.514,P=0.034). Conclusion Limited laminectomy combined with foraminal stenosis decompression could relieve the spinal cord com-pression and restrict the excessive back drift, promote the neurological function recovery and reduce the inci-dence of C5palsy.

目的 观察椎间隙扩大减压椎间融合内固定术在治疗全椎板减压术后颈髓再次前方受压的临床疗效.方法 2013年10月～2016年05月有27例全椎板减压术后前方致压物再次压迫颈髓的患者在我院接受手术治疗,均采用颈前路椎间隙扩大减压椎间融合内固定术治疗,其中男15例,女12例,年龄55～76岁,平均65.1岁.术后观察患者神经功能恢复、颈椎曲度改变及并发症发生情况.结果 平均手术时间(79.6±13.3)min,术中出血量(73.8±16.1)mL.术后JOA评分由术前的(7.6±2.1)分恢复为术后3个月时的(12.1±3.2)分及末次随访时的12.7±3.4分,不同时间点比较具有统计学意义(P＜0.05),末次随访时神经功能改善率为(47.9±1 1.3)％.术前颈椎曲度指数为(12.2±3.7)％,术后3天为(14.4±3.9)％及末次随访时减小为(14.3±4.0)％,手术前后比较有显著统计学差异(P＜0.05).术中有2例患者发生脑脊液漏,行腰大池置管引流及加压包扎后切口均Ⅰ期愈合.结论 颈前路椎间隙扩大减压椎间融合内固定术是一种有效的翻修术式,可充分除脊髓前方压迫并促进神经功能恢复,同时能够较好的维持颈椎稳定性.

Objective To investigate the clinical effects of pedicle screw and lateral mass screw fixation combined with laminoplasty to treat cervical spondylotic myelopathy(CSM) with kyphosis.Methods A total of 33 cases of CSM patients with poor curvature accepted the procedure of pedicle screw and lateral mass screw fixation combined with laminoplasty were selected.The postoperative neurological recovery,cervical curvature index(CCI) and complications were recorded and analyzed.Results No spinal cord and nerves injury occurred during the operation.The JOA score,neurological function improvement and CCI were significant increased after the surgery,the difference was statistically significant,but the postoperative 3 months and the last follow-up difference was not statistically significant (P＜ 0.05).However,there was no significant difference between the time point of 3 months after surgery and the final follow-up.There were 13 cases in excellent,16 cases in good,2 cases in common and 2 cases in poor based on axial symptoms evaluation criteria.The AS rate was 12.1％.Conclusion Posterior pedicle screw and lateral mass screw fixation combined with laminoplasty could correct the patient's cervical curvature effectively.Moreover,it could significantly promote the neurological function and reduce the axial symptoms occurring.

目的 观察颈后路椎板有限切除联合椎弓根螺钉固定治疗多节段脊髓型颈椎病的临床效果.方法多节段脊髓型颈椎病患者35例,均采用颈后路椎板有限减压联合椎弓根螺钉固定术治疗,术后观察患者神经功能恢复、颈椎曲度指数、轴性症状及C5神经根麻痹发生发生情况.结果手术时间(139.9±24.1)min,术中出血量(285.9±51.3)mL,椎板切除宽度(16.5±1.1)mm;C5水平脊髓漂移距离为(2.8±0.3)mm.术后3个月和末次随访时JOA评分明显高于术前(P<0.05),末次随访时神经功能改善率达到(65.8±13.6)％.末次随访时颈椎曲度指数高于术前(P<0.05).术后4例患者出现轴性症状,发生率为11.4％.2例患者出现C5神经根麻痹,发生率为5.7％.结论颈后路椎板有限切除联合椎弓根螺钉固定可解除脊髓压迫并促进神经功能恢复,避免颈椎后凸畸形,降低轴性症状及C5神经根麻痹的发生率.