颈前路椎体次全切除术治疗短节段后纵韧带骨化症的疗效分析  

Analysis on the Effect of Cervical Anterior Corpectomy in the Treatment of Ossification of the Posterior Longitudinal Ligament of Short Segment

作　　者：霍喜卫[1] 胡成栋[1] 陈怀志[1] 周玉军[1] 李东风[1] 王瑞[1] 王飞[1] 

机构地区：[1]邯郸市中心医院骨2科,河北邯郸056001

出　　处：《医学综述》2014年第22期4187-4188,共2页Medical Recapitulate

基　　金：河北省科技计划项目(12277750)

摘　　要：目的探讨颈前路椎体次全切除内固定术治疗短节段颈椎后纵韧带骨化症（OPLL）的疗效及术中并发症的发生情况。方法选取2008年5月至2010年3月在邯郸市中心医院采用颈前路椎体次全切除＋钛网植入内固定术治疗的短节段OPLL患者32例,观察并记录所有患者手术时间、术中出血量、术后神经功能恢复情况及手术并发症的发生情况。结果手术时间为53-120（81.8±23.5）min,术中出血量为60-520（210.7±56.2）m L,术中6例患者发生脑脊液漏,经积极治疗后均愈合。随访时间16-42（25.6±4.2）个月,患者日本骨科协会颈髓功能评分从术前的（6.8±3.6）分提高至术后3个月的（13.1±5.6）分及末次随访时的（13.9±5.3）分,差异有统计学意义（P〈0.05）,至末次随访时,神经功能恢复率平均为（70.6±17.0）%。结论颈前路椎体次全切除＋钛网植入内固定术是治疗短节段后纵韧带骨化症的有效术式,可从前方直接切除骨化物达到直接减压目的,但术中需注意硬膜粘连及脑脊液漏的发生。Objective To investigate the clinical effects and complications of anterior corpectomy and internal fixation in the treatment of ossification of the posterior longitudinal ligament（ OPLL） of short segment. Methods From May 2008 to Mar. 2010,32 cases of OPLL patients received the procedure of anterior corpectomy combined with titanium mesh implant and internal fixation in Handan Central Hospital. The operative time,blood loss,postoperative neurological recovery and complications were recorded and analyzed.Results The mean operative time was 53-120（ 81. 8 ± 23. 5） min with a blood loss of 60-520（ 210. 7 ±56. 2） m L. A total of 6 cases of cerebrospinal fluid leakage occurred during the decompression stage,all of which healed well after suitable therapy. The follow up time was 16-42（ 25. 6 ± 4. 2） months. The Japanese Orthopedic Association（ JOA） scale was improved form（ 6. 8 ± 3. 6） preoperatively to（ 13. 1 ± 5. 6） three months after surgery,and（ 13. 9 ± 5. 3） at the final follow up（ P〈 0. 05）,with a neurological recovery rate of（ 70. 6 ± 17. 0） %. Conclusion Anterior corpectomy and internal fixation can extirpate the ossified tissues directly and improve the neurological function effectively for OPLL of cervical short segment. However,great attention should be paid in dural sac adhesion cases to avoid cerebrospinal fluid leakage.

关 键 词：颈椎 后纵韧带骨化症 手术疗效 并发症 

分 类 号：R681.55[医药卫生—骨科学]