后纵韧带切除与保留在脊髓型颈椎病前路减压术中的疗效比较  

Comparison of therapeutic efficacy between posterior longitudinal ligament resection and reserve in anterior cervical decompression

作　　者：刘建波[1] 吕会强[1] 乔永东[2] 王自立[2] 丁惠强[2] 赵浩宁[2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2010年第9期784-785,共2页Ningxia Medical Journal

摘　　要：目的比较颈椎前路减压术中后纵韧带(PLL)切除与保留的疗效。方法应用前路减压术治疗脊髓型颈椎病(CSM)患者68例,后纵韧带切除组27例,保留组41例。按照日本骨科协会(JOA)评分系统进行临床疗效评价,应用MR I技术测量脊髓矢状径并比较手术前后椎管矢状径及硬模囊压迹的变化。结果平均随访28个月,后纵韧带切除组神经功能恢复率为(76±21)%,显著高于后纵韧带保留组[(62±24)%,P<0.01]。后纵韧带切除组术后脊髓矢状径增加值为(3.26±1.05)mm,显著高于后纵韧带保留组[(2.32±1.23)mm,P<0.01]。结论颈椎前路减压术中对退变的后纵韧带切除可使病变节段减压更加彻底,临床疗效优于保留后纵韧带。Objective To compare the effects between posterior longitudinal ligament （PLL） resection and reserve in anterior cervical decompression. Methods The clinical data of 68 cases which had been carried out anterior cervical decompression and internal plate fixation in the treatment of cervical spondylotic myelopathy were reviewed, and there were 27 cases PLL resection group and there were 41cases PLL reserve group. The Japanese Orthopedic Association （JOA） scoring system was used for evaluation of clinical outcomes. Sagittal diameter of spinal cord on MRI in 2 groups was compared. Results All 68 cases were followed up from 6 months to 56 months （ the mean follow up were 28 months）. The spinal cord neurological function recovery rate of posterior longitudinal ligament resection group were 76%±21%. It was better than that in posterior longitudinal ligament reserve group 62% ±24% （P 〈0. 01 ）. The increment of sagittal diameter of spinal cord was （3.26 ±1.05 ） mm in PLL resection group and （2.32 ± 1.23 ）mm in PLL reserve group （ P 〈 0.01 ） Conclusion The decompression effect is more completely after resection of hypertrophic PLL during anterior cervical decompression and it can obtain better clinical effect in the treatment of CSM.

关 键 词：后纵韧带 脊髓型颈椎病 前路减压 

分 类 号：R687.3[医药卫生—骨科学]