术后围领佩戴时间对颈椎轴性症状的影响

关键词：颈椎病 椎板成形术 轴性症状 康复

Keywords:cervical spondylotic myelopathy  laminoplasty  axial symptoms  rehabilitation

摘要：

      目的：评估颈椎单开门椎板成形术后不同的围领佩戴时间对颈椎轴性症状的影响。方法：28例行颈椎单开门椎板成形术后佩戴围领4周的颈椎病患者作为试验组（A组）．另30例术后佩戴围领12周的颈椎病患者作为对照组（B组）。对患者术前、术后的神经功能恢复情况、轴性症状、颈椎曲度指数、颈后肌群横截面积加以比较评估。结果：两组患者术后神经功能恢复情况并无显著差别．A组患者颈后肌群萎缩率显著小于术后佩戴围领12周的患者（P〈0，01）．颈椎曲度得到有效维持．同时术后发生AS患者的比例显著小于B组患者（P〈0．05）。结论：颈椎板成形术后早期去围领进行功能训练可以有效防止颈后肌群萎缩．减少轴性症状的发生。

Abstract:

      Objective:To assess the degree of influence on cervical axial symptom due to the different duration of wearing a cervical collar in patients undergoing open-door laminoplasty.Method:Twenty-eight patients with cervical myelopathy who underwent open-door laminoplasty and wore a cervical collar for 4 weeks postoperatively were followed for an average of 27.5 months(group A).A second group of 30 patients who underwent laminoplasty and wore a cervical collar for 12 weeks was followed for an average of 30.9 months servered as controls(group B).In both groups,neurologic recovery rate,incidence of axial symptom,cervical curvature index,cross-sectional areas of the cervical posterior muscles were recorded and compared.Result:There was no significant difference in neurologic recovery between the two groups.In group A,atrophy rate of cross-sectional areas of the cervical posterior muscles was significantly smaller than group B and sagittal alignment of cervical spine was also maintained.At the same time,the rate of patients who have axial symptom is lower in group A than the rate in group B.Conclusion:It is speculated that early removal of the cervical collar can prevents postoperative atrophy of extensor musculature and lower the incidence of axial symptom postoperatively.