目的 总结分析颈椎后路双开门椎管扩大成形同种异体骨植骨治疗脊髓型颈椎病的临床效果.方法 对61例行颈椎后路“双开门”椎管扩大成形同种异体骨植骨治疗的脊髓型颈椎病患者进行回顾性分析,采用JOA评分法、颈椎管平均矢状径评价临床疗效,X线、CT判定植骨融合状况.结果 术后所有患者症状体征得到改善,JOA评分由术前平均10.6分增加至术后1年时平均15.2分,改善率为71.8％.手术前后下颈椎的各节段椎管矢状径均值差异有显著性,术后各节段椎管矢状径皆超过14 mm,椎管扩大明显.术后3年同种异体骨骨性融合率为94.4％.结论 应用同种异体骨的颈椎后路双开门椎管扩大成形术是一种安全、有效、有应用价值的手术方法.%Objective To study the result of posterior cervical bilateral open-door expansive laminoplasty with allogenic bone. Methods Retrospective reviews were done to 61 patients underwent posterior cervical bilateral open-door expansive laminoplasty with allogenic bone. All patients were evaluated by JOA scores and cervical canal sagittal diameter.Bone fusion was detemined on x-ray and CT at follow-up. Results All patients were followed up for an average of 3 years and 2 months. Clinical symptoms and physical signs were improved in all the patients after operation. JOA scores increased from 10.6 to 15.2 on an average,the improvement rate of JOA scores was 71.8%. There was significant difference between the mean of sagittal diameter of each segment vertebral canal and after operation the mean of sagittal diameter of each segment was more than 14 mm. The union rate of allogenic bone was 94.4%in 3 years. Conclusion Bilateral open-door expansive laminoplasty with allogenic bone is safe and effective. Allogenic bone is applicable and promising in the cervical posterior bilateral open-door expansive laminoplasty.
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