老年颈椎后纵韧带骨化症患者后路术式疗效比较  

Comparative study on the outcome of different posterior surgical procedures for elderly patients with cervical ossification of the posterior longitudinal ligament

作　　者：王刚[1] 刘军[1] 吴涛[1] 黄鑫鹏[1] 李威霖[1] 王彬彬[1] 

机构地区：[1]南京医科大学第二附属医院骨科,江苏省南京市210011

出　　处：《实用老年医学》2013年第11期948-951,954,共5页Practical Geriatrics

摘　　要：目的比较后路全椎板间接减压内固定植骨融合术与后路单开门椎管成形术两种术式治疗颈椎后纵韧带骨化(OPLL)症老年患者的疗效。方法共有47例患者入选,男27例,女20例,平均年龄(65.7±8.3)岁,随访时间6月至3年。上述OPLL症患者按照手术术式分为椎管成形术组与椎板减压术组。记录2组患者年龄、性别、手术时间、术中出血量、日本骨科协会(JOA)评分(术前、术后1周、末次随访)、视觉模拟量表(VAS)评分(术前、术后1周、末次随访)、JOA评分改善率以及VAS评分改善率,比较两种手术术式疗效差异。结果椎管成形术组入选患者29例,全椎板减压术组患者18例。2组患者在手术时间、出血量、术后VAS评分及改善率指标上均存在显著性差异(P<0.05),其余指标2组间未见显著性差异(P>0.05)。结论虽然颈椎后路全椎板减压术可以早期较好地减轻老年OPLL症患者颈项部疼痛症状,但2种术式远期疗效相近,且颈椎后路椎管成形术具有手术时间、术中出血少等优势,因此,建议老年OPLL症患者应尽可能首选颈椎后路椎管成形术治疗。Objective To compare the clinical outcome of two different surgical procedures for elderly patients with cervical ossification of the posterior longitudinal ligament( OPLL). Methods Forty-seven patients were enrolled in this study,including 27 men and 20 women,with a mean age of 65. 7 ± 8. 3 years. The follow-up period ranged from 6 months to 3 years. According to the surgical procedures,laminoplasty or laminectomy,these patients were divided into two groups. Then age,gender,surgical time,blood loss,JOA score and VAS score( before surgery,one week after surgery and in the last follow-up) were recorded and compared between two groups. Results There were 29 patients receiving laminoplasty and 18 patients receiving laminectomy in this study. Significant differences were found in surgical time,blood loss and VAS scores one week after surgery. Conclusions Although laminectomy can relieve more the cervical pain in early stage, there were no significant difference in the long-term outcome between laminoplasty and laminectomy. Besides,laminoplasty can obviously reduce surgical time and blood loss. Therefore,laminoplasty might be a better choice for elderly patients with OPLL who need a surgical treatment.

关 键 词：颈椎后纵韧带骨化 颈椎后路全椎板减压术 颈椎后路椎管成形术 老年人 

分 类 号：R687.3[医药卫生—骨科学]