改良椎板整块切除、选择性扩大减压结合内固定治疗多节段颈椎病的[摘要]目的探?多节段颈椎病患者采用改良椎板整块切除、选择性扩大减压结合内固定治疗的临床效果。方法选取本院2015年2月～2017年1月收治的84例多节段颈椎病患者，随机分为对照组与观察组，各42例。对照组患者采用常规椎板减压融合内固定术，观察组患者给予“单开门”改良椎板整块切除、选择性扩大减压结合钉棒系统内固定术治疗。比较两组患者的术后神经功能与颈椎功能改善效果以及并发症发生率。结果两组患者手术后的JOA评分、NDI评分与颈椎活动度均好于手术前，且观察组患者手术后的JOA评分、NDI评分与颈椎活动度均明显好于对照组，差异有统计学意义（P<0.05）。观察组患者术后的轴性疼痛与C5神经根麻痹并发症发生率明显低于对照组，差异有统计学意义（P<0.05）。结论改良椎板整块切除、选择性扩大减压结合钉棒系统内固定治疗多节段颈椎病可显著恢复患者的神经功能与颈椎功能，促进颈椎活动度改善，并积极抑制手术并发症情况。[关键词]多节段颈椎病；改良椎板整块切除；选择性扩大减压；内固定术[]R681.5[文献标识码]A[]1674-4721（2017）10（c）-0052-03ClinicalapplicationstudyofmodifiedlaminectomyandselectiveextendeddecompressionplusinternalfixationinthetreatmentofmultiplesegmentalcervicalspondylosisRAOYi-kangOUYANGShao-mingZENGShen-juanZHONGXue-pingGAOYong▲DepartmentofOrthopaedics，theSecondPeople′sHospitalofPingxiangCityin激angxiProvince，Pingxiang337000，China[Abstract]ObjectiveToinvestigatetheclinicaleffectsofapplicationofmodifiedlaminectomy，selectivedecompressionandinternalfixationinthetreatmentofpatientswithmultiplesegmentalcervicalspondylosis.MethodsAltogether84patientswithmultiplesegmentalcervicalspondylosiswhoweretreatedinourhospitalfromFebruary2015toJanuary2017wereselectedandrandomlydividedintothecontrolgroupandtheobservationgroup，with42casesineachgroup.Thecontrolgroupwastreatedwithconventionallaminectomydecompressionandinternalfixation，while，theobservationgroupwastreatedwithsingle-doorimprovedlaminectomyandselectivedecompressioncombinedwithinternalfixationofthepediclescrewsystem.Theneurologicalfunctions，theimprovementofcervicalfunctionsandtheincidenceofcomplicationswerecomparedbetweenthetwogroups.ResultsTheJOAscore，NDIscoreandcervicalmobilityofthetwogroupsafteroperationwerebetterthanthosebeforeoperation，theJOAscore，NDIscoreandcervicalmobilityoftheobservationgroupafteroperationweresignificantlybetterthanthoseofthecontrolgroup，withsignificantdifference（P<0.05）.TheincidenceofpostoperativebackpainandC5nerverootparalysisintheobservationgroupwassignificantlylowerthanthatinthecontrolgroup，withsignificantdifference（P<0.05）.ConclusionApplicationofmodifiedlaminectomy，selectivedecompressioncombinedwithinternalfixationinthetreatmentofmultiplesegmentalcervicalspondylosiscansignificantlyrestorepatients′nervefunctionsandcervicalfunctions，whichpromotestheimprovementofcervicalvertebraactivityandactivelyinhibitsthecomplications.[Keywords]Multiplesegmentalcervicalspondylosis；Modifiedlaminectomy；Selectivedecompression；Internalfixation多节段颈椎病是临床较为常见的慢性进行性颈椎病变[1-2]，发病患者经传统保守治疗无效后则需立即实施手术治疗[3-4]。以往临床中，后路椎板切除术将整块切除与蚕食法为主要方法[5]，但该种治疗方案仍会对患者颈髓形成一定程度的不良作用，进而加重其脊髓功能损害程度。本研究采用改良椎板整块切除、选择性扩大减压结合钉棒系统内固定治疗多节段颈椎病患者，获得满意临床效果，现报道如下。1资料与方法1.1一般资料选取2015年2月～2017年1月我院骨科收治的84例多节段颈椎病患者，所有患者...