颈椎后纵韧带骨化症手术时机的初步探讨  

Preliminary study of the optimal time for operation on patients with ossification of the posterior longitudinal ligament of the cervical spine

作　　者：黄平[1] 陈德玉[1] 卢旭华[1] 杨海松[1] 陈宇[1] 田海军[1] 

机构地区：[1]第二军医大学长征医院,上海200003

出　　处：《中国矫形外科杂志》2009年第19期1459-1461,共3页Orthopedic Journal of China

摘　　要：[目的]探讨颈椎后纵韧带骨化症患者的手术时机。[方法]回顾性分析研究168例颈椎后纵韧带骨化症患者的临床症状、症状持续的时间以及临床症状出现加重至必须手术干预治疗的时间间隔,初步探讨颈椎后纵韧带骨化症患者的手术时机。[结果]颈椎后纵韧带骨化症患者从出现感觉运动障碍的脊髓受压症状起至必需手术治疗的平均时间约27.6个月,而四肢肌力开始出现减退至必需手术治疗的平均时间约为17.4个月,四肢症状明显加重尤其下肢肌力减退至手术治疗的平均时间为5.3个月。[结论]颈椎后纵韧带骨化症诊断明确后宜早期手术;在影像学上有明确的后纵韧带肥厚骨化伴脊髓严重受压(椎管狭窄率>60%)、或四肢尤其下肢开始出现肌力减退时应考虑及早手术治疗。[ Objective] To explore the optimal time for the surgical operation on patients with ossification of the posterior longitudinal ligament of the cervical spine. [ Methods ] The clinical symptoms, the persistent time of the symptoms and the in- terval from exacerbation to operation in 168 patients with OPLL were analyzed. [Results] The average time was 27. 6 months from the onset of myelopathy to the operation on patients with OPLL, and 17.4 months from the decrease of muscle strength in extremities to the operation, and 5.3 months from the symptomatic exacerbation of the extremities especially the decrease of mus- cle strength in lower extremities to the operation. [ Conclusion] The patient should be treated earlier by surgical operation after his/her illness has been diagnozed as OPLL. It is the optimal time for surgical operation when the patient has imaging change of hypertrophy or ossification of the posterior longitudinal ligament and severe compression of spinal cord （ more than 60% spinal canal stenosis）, or the decrease of muscle strength in extremities especially in lower extremities.

关 键 词：颈椎 后纵韧带骨化 手术时机 

分 类 号：R687.3[医药卫生—骨科学]