[1]葛邦新,王　博,赵俊涛,等.多节段脊髓型颈椎病患者颈椎后路单开门椎管扩大成形术联合微型钢板内固定术后早期康复锻炼效果观察[J].新乡医学院学报,2020,37(1):083-86.[doi:10.7683/xxyxyxb.2020.01.020]
　GE Bangxin,WANG Bo,ZHAO Juntao,et al.Effect of early rehabilitation exercise on patients with multilevel cervical spondylotic myelopathy after posterior unilateral open-door laminoplasty combined with mini-plate internal fixation[J].Journal of Xinxiang Medical University,2020,37(1):083-86.[doi:10.7683/xxyxyxb.2020.01.020]
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多节段脊髓型颈椎病患者颈椎后路单开门椎管扩大成形术联合微型钢板内固定术后早期康复锻炼效果观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年1
页码:
083-86
栏目:
临床研究
出版日期:
2020-01-05

文章信息/Info

Title:
Effect of early rehabilitation exercise on patients with multilevel cervical spondylotic myelopathy after posterior unilateral open-door laminoplasty combined with mini-plate internal fixation
作者:
葛邦新; 王　博; 赵俊涛; 刘冬冬; 董艳芳
（鹤壁市人民医院骨一科，河南　鹤壁　458030）
Author(s):
GE Bangxin; WANG Bo; ZHAO Juntao; LIU Dongdong; DONG Yanfang
(Department of Osteology，the People′s Hospital of Hebi City，Hebi 458030，Henan Province，China)
关键词:
多节段脊髓型颈椎病; 椎管扩大成形术; 内固定术; 早期康复锻炼; 轴性症状
Keywords:
multilevel cervical spondylotic myelpathy; laminoplasty; internal fixation; early rehabilitation exercise; axial symptom
分类号:
R681.5
DOI:
10.7683/xxyxyxb.2020.01.020
文献标志码:
A
摘要:
目的　探讨多节段脊髓型颈椎病（MCSM）患者颈椎后路单开门椎管扩大成形术联合微型钢板内固定术后早期康复锻炼的临床效果。方法　选择2014年9月至2017年6月鹤壁市人民医院收治的MCSM患者60例，所有患者行第3～7颈椎单开门椎管扩大成形术和微型钢板内固定术，术后将患者分为观察组和对照组，每组30例。观察组患者术后不佩戴颈托，术后第2天即开始康复锻炼；对照组患者术后即刻佩戴颈托，3周后去除颈托开始康复锻炼。分别于术前及术后3、6、12、18个月时根据日本骨科协会（JOA）评分标准评估患者颈部脊髓功能，分别于术前及术后12个月测量患者颈椎活动度（ROM）和颈椎曲度，术后12个月评定患者轴性症状发生情况。结果　2组患者术前JOA评分比较差异无统计学意义（P>0.05）；2组患者术后3、6、12、18个月时JOA评分显著高于术前（P＜0.05），2组患者术后3、6、12、18个月时JOA评分比较差异无统计学意义（P>0.05）。2组患者术前颈椎ROM、颈椎曲度比较差异无统计学意义（P>0.05），2组患者术后12个月颈椎ROM和颈椎曲度小于术前（P＜0.05）；术后12个月，观察组患者颈椎ROM和颈椎曲度大于对照组（P＜0.05）。术后12个月时，观察组和对照组患者轴性症状发生率分别为20.0%（6/30）、50.0%（15/30），观察组患者轴性症状发生率低于对照组（χ2=3.955，P＜0.05）。结论　MCSM患者行后路单开门椎管扩大成形术联合微型钢板内固定术后不佩戴颈托进行早期康复锻炼安全可行，能有效降低颈椎ROM和颈椎曲度的丢失，降低术后轴性症状发生率。
Abstract:
Objective　To investigate the clinical effect of early rehabilitation exercise on patients with multilevel cervical spondylotic myelopathy(MCSM) after posterior unilateral open-door laminoplasty combined with mini-plate internal fixation.Methods　Sixty patients with MCSM admitted to the People′s Hospital of Hebi City from September 2014 to June 2017 were selected as the study subjects.All patients underwent posterior unilateral open-door laminoplasty combined with mini-plate internal fixation through the 3rd to 7th cervical vertebra.The patients were divided into observation group and control group after operation，with 30 cases in each group.The patients in the observation group did not wear the neck bracket after operation，and began rehabilitation exercise on the second day after operation;while the patients in the control group immediately wore the neck bracket for three weeks after operation，and began rehabilitation exercise after removing the neck bracket.The cervical spinal cord function was evaluated according to the Japanese Orthopaedic Association(JOA) score before and 3，6，12，18 months after operation.The cervical range-of-motion(ROM) and curvature were measured before and 12 months after operation.The axial symptom was evaluated at 12 months after operation.Results　There was no significant difference in JOA score between the two groups before operation (P>0.05).The JOA score at 3，6，12，18 months after operation was significantly higher than that before operation in the two groups (P＜0.05).There was no significant difference in JOA score between the two groups at 3，6，12 and 18 months after operation (P>0.05).There was no significant difference in cervical ROM and curvature between the two groups before operation (P>0.05).The cervical ROM and curvature at 12 months after operation were less than those before operation in the two groups (P＜0.05).The cervical ROM and curvature in the observation group were higher than those in the control group at 12 months after operation (P＜0.05).At 12 months after operation，the incidence of axial symptom in the observation group and the control group was 20.0% (6 / 30) and 50.0% (15 / 30)，respectively;and the incidence of axial symptom in the observation group was lower than that in the control group (χ2=3.955，P＜0.05).Conclusions　It is safe and feasible for patients with MCSM to carry out early rehabilitation exercise without wearing neck bracket after posterior unilateral open-door laminoplasty combined with mini-plate internal fixation，which can effectively reduce the loss of cervical ROM and curvature and reduce the incidence of axial symptom.

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[1]刘卫祥.保留与非保留单侧肌肉韧带颈椎后路单开门椎管扩大减压术联合微型钛板固定术治疗多节段脊髓型颈椎病疗效比较[J].新乡医学院学报,2018,35(8):727.[doi:10.7683/xxyxyxb.2018.08.020]
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更新日期/Last Update: 2020-01-05