摘要
目的:总结后前路联合手术治疗颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)的效果。方法:2002年9月～2006年1月采用后前路联合手术治疗25例重型颈椎后纵韧带骨化症患者,男17例,女8例;年龄32～75岁,平均53.5岁。均先采用颈椎后路单开门椎管成形术,1周后再行颈椎前路减压植骨或钛网置入内固定术。前路减压涉及1个椎间隙2例,2个椎间隙1个椎体10例,3个椎间隙2个椎体及以上13例。术前、术后依据JOA评分标准评估患者的神经功能,比较术前、术后随访时JOA评分。结果:术后并发脑脊液漏2例,节断性神经根麻痹1例,并发颈部血肿者3例。随访3～24个月,平均13.5个月,术前患者JOA评分为7.1±1.1分,术后为14.9±0.9分,3个月随访时为15.1±0.8分,术后3个月平均改善率为79.48%。结论:采用先行后路椎管扩大成形术1周后再行前路减压植骨术治疗颈椎OPLL可彻底切除病灶、使脊髓减压完全,疗效较好。
Objective：To discuss the anterior-posterior surgical operation for ossification of posterior longitudinal ligament（OPLL） of cervical vertebrae and its curative effect.Method：Totally 25 patients with severe OPLL of cervical vertebrae operated by posterior-anterior approach surgical treatments from September in 2002 to January in 2006 were retrospectively analyzed.Among the 25 patients,17 males and 8 females.Their age averaged 53.5 years （ranged,32-75 years）.Two cases with lesions involving one intervertebral space,the other 23 cases involving two or at least three intervertebral spaces respectively.All cases had the posterior cervical open-door laminoplasty decompression in first,and then had the anterior cervical decompression and bone grafting or fusion with titanium cage internal fixation in a week.All cases were followed-up,neural function was recorded.According to JOA score,preoperative score and postoperative followed-up score were compared, improvement rate was calculated respectively.Result：There were 2 patients with dural tear,2 with segmental nerve root palsy and 2 with hematoma after operation.All cases were regularly followed up.The duration of follow up averaged 13.5 months （ranged,3-24 months ） .The pre-operation JOA score was 7.1±1.1,the JOA score after operation was 14.9±0.9,and the JOA was 15.1±0.8 after three months.The improvement rate of posterior-anterior unites to cure the severe OPLL of the cervical vertebrae was 79.5%.Conclusion：Combined anterior-posterior decompression and internal fixation is a good alternative for treatment of OPLL,which is able to remove the area of disease thoroughly,decompress the spinal cord completely,raise the clinical improvement rate and reduce the complications.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2008年第2期103-107,共5页
Chinese Journal of Spine and Spinal Cord
关键词
颈椎
后纵韧带骨化症
手术治疗
后前路
Cervical spine
Ossification of posterior longitudinal ligament
Surgical operation
Anterior-posterior
作者简介
李永军,男（1978-），医师，医学硕士，研究方向：脊柱外科，电话：（0311）87027951-3115,E-mail：xingtailyj@126．com
