后前路联合手术治疗严重的颈椎后纵韧带骨化症  

Combined posterior and anterior surgical treatment of severe cervical ossification of the posterior longitudinal ligament

作　　者：李韬[1] 赵智[1] 解京明[1] 王迎松[1] 张颖[1] 杨振东[1] 刘路平[1] 

机构地区：[1]云南省昆明医学院第二附属医院骨科,云南昆明650101

出　　处：《颈腰痛杂志》2010年第6期416-420,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的评价后前路联合手术治疗严重颈椎后纵韧带骨化(矢状径占位率>70%)患者的临床疗效,评估其安全性及有效性。方法回顾性分析2005-01-2008-12在我院接受后前路联合手术治疗的16例严重颈椎后纵韧带骨化病例,通过JOA评分,恢复率,颈椎前凸值,MRI等指标进行评价。结果平均随访(30.4±10)个月,术后JOA评分从术前平均(7.6±1.8)分提高到(14.1±1.5)分(P<0.05),随访最后的JOA评分均值为(15.1±1.2)分。术后优良率为93.75%。术后颈椎前凸力线得到恢复,随访中没有出现前凸角度的丢失。术中、术后没有观察到脑脊液漏、神经功能障碍恶化、内固定失败等并发症。但该治疗方案手术时间较长、出血量较多,技术难度大。结论颈椎后前路联合手术在治疗严重颈椎后纵韧带骨化症时能取得理想的治疗效果,并能明显减少单纯前路或后路手术的相关并发症,但其要求较高的手术技术。Objective To evaluate surgical outcomes and prognostic factors of severe cervical ossification of the posterior longitudinal ligament treated by combined posterior and anterior surgery.Methods 16 cases of severe cervical ossification of the posterior longitudinal ligament from 2005.1-2008.12 were treated by combined posterior and anterior surgery.Japanese Orthopedic Association（JOA）scores,recovery rates,cervical lordosis.MRI were used to evaluate the outcomes.Results The mean follow-up period were（30.4±10）months,The mean pre-and postoperative JOA scores were 7.6±1.8 points and（14.1±1.5）points（P0.05）,respectively,and the recovery rate were 93.75%.The fi-nal JOA scores were（15.1±1.2）points.The cervical lordosis were restored,and there were no loss during follow-up.There were no complication such as cerebrospinal fluid,neurologic deterioration,and failure of the internal fixation.However,the combined posterior and anterior surgery was very difficult,bleeding and required long operative time.Conclusion While offer good outcomes in treating severe cervical ossification of the posterior longitudinal ligament,combined posterior and anterior surgery can also reduce the complications.However,the combined posterior and anterior surgery is a complicated,high-risk procedure.

关 键 词：颈椎 后纵韧带骨化症 手术 

分 类 号：R681.55[医药卫生—骨科学]