颈椎椎板切除融合术后轴性疼痛

目的：目前已证实颈椎椎板切除融合术是治疗多阶段的脊髓型颈椎病和后纵韧带骨化病的一种安全和有效的方法。然而,颈椎椎板切除融合术后经常发生颈部轴性疼痛。本研究的目的是观察C7棘突保留与否与颈椎椎板切除融合术后轴性疼痛的关系。方法：对2006年1月～2008年12月在我院行颈椎椎板切除融合术的67个病人进行回顾性分析。将这67个病人之中保留了C7棘突的29名病人称为A组,未保留C7棘突的38名病人称为B组,对两组病人的轴性症状、颈椎曲度和颈椎曲度指数（cervical curbature index,CCI）进行评估和比较。结果：在A组中有51.7%的病人发生了早期的轴性症状,10.3%的病人发生了晚期的轴性症状,B组分别为60.5%和42.1%。B组中42.1%的病人和A组中10.3%的病人在手术后晚期有轴性症状,A组的轴性疼痛发生率低于B组,有统计学意义（p=0.001）。结论：保留C7棘突可以降低颈椎椎板切除融合术后轴性症状的发生率。

Axial Neck Pain after Cervical Laminectomy with Instrumented Fusion

Objective：It has been demonstrated that cervical laminectomy with instrumented fusion is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament.However,axial neck pain is frequently encountered after cervical laminectomy with instrumented fusion.The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminectomy with instrumented fusion.Methods：A total of 67 consecutive patients that underwent cervical laminectomy with instrumented fusion between Janurary 2006 and December 2008 were reviewed.The authors evaluated and compared axial neck pain 、 lordotic angle and cervical curbature index（CCI） in patients that underwent C7 spinous process preserving surgery（groupA,n = 29） and in patients in which the C7 spinous process was sacrificed（groupB,n = 38）.Results：Early axial pain occurred in 51.7% of patients in group A and in 60.5% in group B.Late axial pain occurred in 10.3% in group A and in 42.1% in group B.42.1% in group B and 10.3% in group A had axial neck pain at late postoperative period and late axial neck pain was significantly less common in group A（P0.05）.Conclusion：The present study demonstrates that C7 spinous process preserving decreases the incidence of late axial neck pain after cervical laminectomy with instrumented fusion.