后纵韧带的切除与保留在颈椎人工椎间盘置换术中的临床观察  

Resection or preservation of the posterior longitudinal ligament in cervical artificial disc replacement: a clinical analysis

作　　者：吕永威 李利[1] 郭继东[1] 王华东[1] 马超[1] 

机构地区：[1]解放军总医院第一附属医院骨科,北京100048

出　　处：《中国矫形外科杂志》2016年第23期2113-2118,共6页Orthopedic Journal of China

摘　　要：[目的]比较颈椎人工椎间盘置换术中颈椎后纵韧带（posterior longitudinal ligament,PLL）切除与保留的疗效及对颈椎曲度和活动度的影响。[方法]对本科2009年12月~2013年04月因颈椎病行单节段Pro Disc-C颈椎人工椎间盘置换术且有完整临床资料的28例患者行回顾性分析,根据术中是否切除颈椎PLL,分为颈椎PLL切除组（15例）和颈椎PLL保留组（13例）,比较两组患者的一般情况、影像学结果及临床疗效。[结果]两组患者年龄、性别分布、诊断类型、病变节段、手术时间、术中出血量、随访时间差异均无统计学意义（P〉0.05）。两组患者末次随访时置换节段Cobb角、颈椎整体曲度、置换节段活动度差异均无统计学意义（P〉0.05）。两组患者末次随访时颈痛VAS评分差异及JOA脊髓功能评分改善率差异均有统计学意义（P〈0.05）。随访期间未发现严重并发症。[结论]颈椎PLL切除与否对置换节段曲度及活动度影响不大,切除颈椎PLL在提高颈椎人工椎间盘置换患者的临床疗效方面优于保留颈椎PLL。[ Objective ] To investigate the effect of resection or preservation of posterior longitudinal ligament （PLL） in cervical artificial disc replacement and its influence on cervical curvature and range of motion. [ Methods ] A retrospective anal- ysis was performed for the complete clinical data of 28 patients who underwent single - segment ProDisc - C cervical artificial disc replacement in our department from December 2009 to April 2013. According to the resection or preservation of PLL during surgery, these patients were divided into PLL resection group （ 15 patients） and PLL preservation group （ 13 patients） . The general status, radiological findings, and clinical outcome were compared between the two groups. [ Results ] The age, sex distribution, diagnostic type, segment with lesions, time of operation, intraoperative blood loss, and follow - up time showed no significant differences between the two groups （P 〉 0. 05 ） . At the final follow - up visit, the Cobb angle of the replaced seg- ment, cervical curvature, and range of motion of the replaced segment showed no significant differences between the two groups （P 〉 0. 05 ）, while the visual analogue scale score of neck pain and improvement rate of Japanese Orthopaedic Association spinal cord function score showed significant differences between the two groups （ P 〈 0.05 ） . There were no serious complications dur- ing follow - up. [ Conclusion] Resection or preservation of the cervical PLL has no significant influence on the curvature and range of motion of the replaced segment, but resection of the PLL has a better clinical effect in patients undergoing cervical arti- ficial disc replacement than preservation of the PLL

关 键 词：颈椎 后纵韧带 人工椎间盘置换术 ProDisc-C 

分 类 号：R687.3[医药卫生—骨科学]