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[1]柴旭斌,周英杰,鄭懷亮,等.納米羥基磷灰石/聚酰胺66人工骨塊在頸椎后路雙開門椎管成形術(shù)中的應(yīng)用[J].中醫(yī)正骨,2016,28(08):32-34.
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納米羥基磷灰石/聚酰胺66人工骨塊在頸椎后路雙開門椎管成形術(shù)中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年08期
頁碼:
32-34
欄目:
臨床報道
出版日期:
2016-08-20

文章信息/Info

作者:
柴旭斌周英杰鄭懷亮趙剛趙鵬飛王少純
河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 洛陽 471002
關(guān)鍵詞:
頸椎病 椎管狹窄 后縱韌帶骨化 頸椎后路雙開門椎管擴大成形術(shù) 納米羥基磷灰石/聚酰胺66 人工骨
摘要:
目的:探討應(yīng)用納米羥基磷灰石/聚酰胺66人工骨塊行頸椎后路雙開門椎管擴大成形術(shù)的臨床療效和安全性。方法:2011年1月至2013年12月收治頸部疾病患者32例。男23例,女9例; 年齡32~78歲,中位數(shù)56歲; 脊髓型頸椎病11例,發(fā)育性頸椎管狹窄癥7例,頸椎后縱韌帶鈣化癥14例; 病程5~15個月,中位數(shù)10個月。均采用頸椎后路雙開門椎管擴大成形術(shù)治療,以納米羥基磷灰石/聚酰胺66人工骨塊作為間隔物。采用日本骨科學(xué)會(Japanese orthopaedic association,JOA)制定的脊髓型頸椎病評分標(biāo)準(zhǔn)(17分法)評定脊髓功能; 進(jìn)行頸椎X線、CT、MRI檢查,觀察頸椎曲度和活動度、植骨塊位置和愈合情況,測定椎管矢狀徑; 觀察記錄治療及隨訪期間的并發(fā)癥發(fā)生情況。結(jié)果:所有患者均行C3~C6后路雙開門椎管擴大成形術(shù),手術(shù)時間(1.6±0.3)h,術(shù)中出血量(188±50)mL。所有患者均獲12個月以上隨訪,切口均甲級愈合,未出現(xiàn)過敏或毒性反應(yīng),均未出現(xiàn)脊髓損傷加重表現(xiàn)。術(shù)后所有患者的癥狀均明顯緩解,3例患者出現(xiàn)單側(cè)或雙上肢燒灼樣疼痛,治療1~3個月后消失; 術(shù)前、術(shù)后1周、術(shù)后3個月、術(shù)后12個月的JOA評分分別為(6.56±2.52)分、(10.82±1.47)分、(11.94±1.63)分、(12.35±1.96)分。影像學(xué)檢查顯示術(shù)后頸椎椎管容積明顯增加、頸脊髓漂移滿意、脊髓壓跡消失; 術(shù)前最狹窄部椎管矢狀徑(8.86±3.69)mm,出院時增加至(14.27±2.54)mm; 植骨塊位置維持良好,所有植骨塊均與棘突融合; 未發(fā)生再關(guān)門、頸椎后凸畸形及頸椎節(jié)段性不穩(wěn)等并發(fā)癥。結(jié)論:應(yīng)用納米羥基磷灰石/聚酰胺66人工骨塊行頸椎后路雙開門椎管擴大成形術(shù),可有效擴大并維持頸椎管容積,促進(jìn)脊髓功能恢復(fù),且植骨愈合良好,并發(fā)癥少,值得臨床推廣應(yīng)用。

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備注/Memo

備注/Memo:
基金項目:河南省重點中醫(yī)學(xué)科學(xué)術(shù)帶頭人基金培養(yǎng)項目(2100601) 通訊作者:周英杰 E-mail:[email protected]
更新日期/Last Update: 1900-01-01