Objective To summarize and analyze the application value of cervical posterior approach double-door expansive laminoplasty combined with hydroxyapatite artificial bone (HAB) grafting in the treatment of multi -segmental cervical spondylotic myelopathy and its effect on the prognosis of cervical spinal cord injury. Methods 100 patients who underwent cervical posterior approach "double-door" expansive laminoplasty combined with HAB grafting were retrospectively investigated and analyzed. Japanese Orthopaedic Association Scores (JOA) method, X-ray combined with CT examination to observe and determine the expansion rate of average sagittal diameter of the cervical canal, ROM, the ratio of forward inclined type in the type of cervical curvature, the stability of the adjacent intervertebral space, and the state of grafting bone fusion were used to evaluate the clinical efficacy. Results Postoperative JOA scores and mean sagittal diameters of the cervical canal in the most narrow part were significantly improved in all patients; cervical ROM was decreased from preoperative angle of (41. 7±10. 1)0 to (25. 1±11. 3).; the ratio of forward inclined type was decreased by 5％ compared with that before the surgery; the total fusion rate of artificial bone in 5 years was 55. 8％. Symptoms and signs were improved, without local abnormal reactions. The difference was statistically significant (P＜ 0. 05). No intervertebral instability was observed during the follow-up visit. Conclusion The application of HAB for cervical posterior approach double-door laminoplasty is a safe, effective, and postoperatively stable surgical procedure.%目的 总结分析颈椎后路双开门椎管扩大成形羟基磷灰石人工骨(Hydroxyapatite artificial bone)即HAB植骨在多节段脊髓型颈椎病中的应用价值和对颈脊髓损伤预后的影响.方法 对100例行颈椎后路"双开门"椎管扩大成形HAB植骨治疗的患者进行回顾性调查分析,采用日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores)JOA评分法、X线片联合CT检查观察判定颈椎管平均矢状径扩大率、ROM、颈椎弯曲类型中前弯型比率、相邻椎间的稳定性、植骨融合状况等评价临床疗效.结果 所有患者术后JOA评分、最狭窄部颈椎管平均矢状径均改善明显;颈椎ROM由术前(41.7±10.1).下降为(25.1±11.3)°;前弯型比率由术前下降5％;5年人工骨完全融合率为55.8％,症状体征得到改善,无局部异常反应,差异有统计学意义(P＜0.05),随访过程中未发现相邻椎间失稳.结论 应用HAB的颈椎后路双开门椎管扩大成形术是一种安全、有效、术后稳定的手术方法.
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