K线在预测颈椎全椎板切除减压治疗多节段后纵韧带骨化症疗效中的应用  

K-line as prediction of prognosis of cervical laminectomy and fusion for the treatment of multilevel cervical ossification of posterior longitudinal ligament

作　　者：贾斌[1] 栾冠楠[2] 陈宇飞[3] 彭页[3] 罗卓荆[1] 杜俊杰[3,1] 

机构地区：[1]第四军医大学西京医院骨科,西安710032 [2]中国科学院文献情报中心,北京100190 [3]空军总医院骨科,北京100142

出　　处：《中国矫形外科杂志》2015年第11期981-985,共5页Orthopedic Journal of China

基　　金：国家自然科学基金课题(编号:81403451);博士后科学基金课题(编号:2014M562560);北京市自然科学基金课题(编号:7154242)

摘　　要：[目的]分析K线在预测颈椎后路全椎板切除减压植骨融合内固定术治疗多节段颈椎后纵韧带骨化症临床疗效及术后并发症中的作用。[方法]回顾性分析2009年6月~2013年6月期间,本科采用颈椎后路全椎板切除减压植骨融合内固定术治疗多节段（≥3个）颈椎后纵韧带骨化症患者28例。分别观察K线阳性组（骨化物未超过K线范围）及K线阴性组（骨化物超过K线范围）术前及术后JOA评分、JOA评分改善率以及两组手术并发症情况。[结果]两组患者年龄、术中出血量、手术时间及术前JOA评分差异无统计学意义（P〉0.05）,术后JOA评分、末次随访时JOA评分、术后平均改善率及末次随访平均改善率K线阳性组患者均高于K线阴性组患者,两组之间差异有统计学意义（P〈0.05）,术后并发症两组间比较差异均无统计学意义（P〉0.05）。[结论]术前通过K线与颈椎后纵韧带骨化症椎管内骨化物的关系,可以有效预测全椎板切除减压植骨融合内固定术治疗多节段颈椎后纵韧带骨化症的临床疗效。[ Objective ] To investigate the effect of K - line as prediction of prognosis of cervical laminectomy and fusion for the treatment of multilevel cervical ossification of posterior longitudinal ligament （OPLL） . [ Methods] Twenty - eight cases with multilevel （ ≥3 segments ） cervical OPLL receiving cervical laminectomy and fusion between June 2009 and June 2013 were retrospectively analyzed. JOA scores, recovery rates of JOA scores and complications rates before and after operation were observed in both K- line positive group （Osteophyte not beyond K- line） and K- line negative group （Osteophyte beyond K- line） . [ Results] No significances of baseline characteristics, including age, operative time, blood loss and JOA scores, in the two groups were observed before operation （P 〉 0. 05） . Higher JOA scores and better recovery rates of JOA scores were ob- served in K - line positive group than K - line negative group after operation and at 1 - year follow - up （ P 〈 0. 05 ） . No signifi- cant differences of postoperative complications between the two groups were observed （P 〉 0. 05） . [ Conclusion] Outcomes of cervical laminectomy and fusion can be effective predicted by observing the spatial relations between the K- line and osteophyte in multilevel cervical OPLL cases.

关 键 词：颈椎 后纵韧带骨化 K线 椎板切除融合术 

分 类 号：R687.3[医药卫生—骨科学]