切除与漂浮后纵韧带在脊髓型颈椎病前路减压术中的疗效对比  

Comparison of therapeutic efficacy between posterior longitudinal ligament resection and floating in anterior cervical decompression for CSM

作　　者：刘英民[1] 朱志强[2] 奚修全[1] 董继兵[1] 

机构地区：[1]兖矿集团总医院脊柱外科,山东273500 [2]济宁市中区人民医院外科

出　　处：《脊柱外科杂志》2007年第1期11-14,共4页Journal of Spinal Surgery

摘　　要：目的比较后纵韧带切除与漂浮在单间隙脊髓型颈椎病前路减压术中的疗效。方法对93例行前路减压植骨内固定治疗的单间隙脊髓型颈椎病患者资料进行分析。其中脊髓明显压迫41例(A组),伴有椎体后缘骨赘形成或椎间盘脱出;椎间盘突出压迫为主;无椎体后缘骨赘形成52例(B组)。按照JOA评分分别比较后纵韧带切除与漂浮术后症状的改善率。结果平均随访16个月,A组中行后纵韧带切除与漂浮平均改善率分别为77%和67%,B组分别为75%和74%。结论对于椎体后缘骨赘形成或椎间盘脱出病例切除韧带术疗效优于漂浮术,对于椎间盘突出压迫为主而无椎体后缘骨赘形成者,两者疗效无明显差异。Objective To compare the value between Posterior Longitudinal Ligament resection and floating in anterior Cervical decompression for single Level CSM. Methods 93 patients with single Level CSM undergoing anterior decpmpression graft fusion and internal fixation were analyzed retrospectively. The spinal cord significantly compressed by posterior osteophyte of centra and hernial intervertebral disk was found in Group A （41 Patients） and for the other 52 patients （Group B）, the compression was caused mainly by hemial intervetebral disk without posterior osteophyte of centra.The amelioration rate was compared between the Ligament resection and floating in the two groups respectively according to JOA score evaluation. Results All patients were followed up for 16 months on average.in Group A,the mean amelioration rate was 77% for patients undergoing resection and was 67% for patients undergoing ligament floating.In guoup B,the mean amelioration rate was 75% and 74% correspondingly.Conclusion For patients with spinal cord compression form posterior osteophyte of centra and hemial intervertebral disk,Ligament resection is more efficient than ligament floating.There is no significant difference between ligament resection and ligament floating in treatment of patients with compression mainly from hernial intervetebral disk without posterior osteophyte of centra.

关 键 词：颈椎 纵韧带 外科手术 

分 类 号：R681.531.1[医药卫生—骨科学]