2018 年第 7 期 第 13 卷

颈椎后路单开门椎管扩大成形术后局部生理曲度与第5颈神经根症状和轴性症状相关性分析

Relation of local physiological curvature of cervical vertebra after posterior single open-door laminoplasty with the fifth cervical radicular symptom and axial symptom

作者：英吉林刘高甬孙会恒滕涛

英文作者：

单位：100062北京市普仁医院骨科

英文单位：

关键词：颈椎病；单开门椎管扩大成形术；颈椎生理曲度；第5颈神经根症状；轴性症状

英文关键词：

• 摘要：

• 【摘要】目的    探讨颈椎后路单开门椎管扩大成形术＋单侧侧块钉棒系统内固定术后颈椎局部生理曲度与第5颈神经（C5）神经根症状和轴性症状的相关性。方法    选取2010年1月至2016年1月于北京市普仁医院行后路单开门椎管扩大成形术＋单侧侧块钉棒系统内固定术的313例脊髓型颈椎病患者。术后摄颈椎X线片测量a角（C3、C4椎体后缘中点连线与C6、C7椎体后缘中点连线夹角）。通过随访观察统计术后3个月C5神经根症状和轴性症状的发生情况。结果    所有患者手术效果良好，生理曲度恢复。305例患者得到随访，随访率97.4%。术后X线片测量a角示0°～10°者89例，＞10°～20°者138例，＞20°者78例。不同a角患者的C5神经根症状发生情况差异有统计学意义（P＜0.05）,而组间轴性症状发生情况差异无统计学意义（P＞0.05）。结论    颈椎后路单开门椎管扩大成形术＋单侧钉棒系统内固定术治疗脊髓型颈椎病患者术后的局部颈椎生理曲度改变与C5神经根症状相关，而与轴性症状发生无关。

• 【Abstract】Objective    To investigate the relation of local physiological curvature of cervical vertebra with the fifth cervical nerve（C5） radicular symptom and axial symptom in patients after posterior single open-door laminoplasty plus unilateral mass screw fixation. Methods    A total of 313 cervical spondylotic myelopathy patients undergoing posterior single open-door laminoplasty plus unilateral mass screw fixation from January 2010 to January 2016 in Beijing Puren Hospital were enrolled. The C3-C4 and C6-C7 mid-point connection angle（A angle） was tested by X-ray after operation. Occurrences of C5 radicular symptom and axial symptom were observed in 3 months after operation. Results    All patients successfully completed operation; cervical curvature recovered well. In 305 patients（97.4%） with follow-up records, X-ray showed A angle 0°-10° in 89 cases, A angle ＞10°-20° in 138 cases and A angle＞20° in 78 cases. Incidence of C5 radicular symptom showed significant difference among patients with different A angle（P＜0.05）. Incidence of axial symptom showed no significant difference among patients with different A angle（P＞0.05）. Conclusion    Change of cervical physiological curvature after posterior single open-door laminoplasty is associated with C5 radicular symptom, but not with axial symptom.

  【Key words】Cervical spondylosis;Single open-door laminoplasty;Cervical physiological curvature;The fifth cervical radicular symptom;Axial symptom