颈椎前路椎体骨化物复合体前移融合术治疗严重颈椎后纵韧带骨化症  

Anterior controllable anteriodisplacement and fusion for treatment of severe cervical ossification of posterior longitudinal ligament

作　　者：孙璟川[1] 史建刚[1] 王元[1] 徐锡明[1] 孔庆捷[1] 韩郸 郑冰[1] 杨勇[1] 王海波[1] 王英杰[1] 杨海松[1] 郭永飞[1] 黄震[1] 

机构地区：[1]第二军医大学长征医院脊柱二科,上海200003

出　　处：《第二军医大学学报》2017年第8期1053-1059,共7页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(81650031);Supported by National Natural Science Foundation of China(81650031);上海市卫生和计划生育委员会项目(201640262);Project of Shanghai Municipal Commission of Health and Family Planning(201640262)

摘　　要：目的报道一项治疗严重颈椎后纵韧带骨化症的新技术,可在不切除骨化物的前提下实现神经的直接减压,弥补传统前路或后路减压手术的不足。方法颈椎前路椎体骨化物复合体前移融合术的手术操作步骤主要包括处理椎间隙、去除椎体前部骨质、安装钛板和椎间融合器、椎体两侧开槽和椎体骨化物复合体前移等。收集2例经该术式治疗的严重颈椎后纵韧带骨化症患者的临床资料并进行分析。结果颈椎前路椎体骨化物复合体前移融合术通过将椎体骨化物复合体游离并前移,实现脊髓和神经根的直接减压。2例患者手术顺利,脊髓减压彻底,神经功能恢复良好,无特殊并发症发生。结论颈椎前路椎体骨化物复合体前移融合术的设计兼顾了前路直接减压的有效性和后路间接减压的安全性,初步疗效证明其可作为严重颈椎后纵韧带骨化症的一种治疗方案。Objective To report a novel technique named anterior controllable antedisplacement and fusion（ACAF）for the treatment of severe ossification of the posterior longitudinal ligament of the cervical spine,which allows for direct decompression of the nerve without resection of the ossification,making up for deficiencies in traditional anterior or posterior decompression.Methods The main surgical procedures of the ACAF included treatment of intervertebral space,removal of the anterior part of vertebrae,installation of titanium plate and interbody fusion cages,bilateral osteotomies of the vertebrae,and antedisplacement of the vertebrae ossification complex.The clinical data of two patients undergoing this surgery for severe ossification of the posterior longitudinal ligament of cervical spine were collected and analyzed. Results ACAF enabled direct decompression of spinal cord and nerve root through antedisplacement of the vertebrae ossification complex.The two patients who underwent ACAF gained satisfactory restoration with decompression of spinal cord and good recovery of neurological function,with no specific complications.Conclusion ACAF surgery takes into account the effectiveness of anterior direct decompression and the safety of posterior indirect decompression.Preliminary results shows that it can be used for severe cervical ossification of the posterior longitudinal ligament.

关 键 词：颈椎病 后纵韧带骨化 前路椎体骨化物复合前移融合术 前路手术 

分 类 号：R681.531[医药卫生—骨科学]