单开门椎板成形术治疗过伸位K线阳性颈椎后纵韧带骨化患者的疗效  

Clinical outcomes of single-door laminoplasty for cervical ossification of the posterior longitudinal ligament with K-line positive in extension radiograph

作　　者：王欢[1] 许金松[1] 郜健茗 WANG Huan;XU Jin-song;GAO Jian-ming(Dept of Orthopaedic Surgery,Anyang District Hospital,Anyang,Henan 455000,China)

机构地区：[1]安阳地区医院骨外科,河南安阳455000

出　　处：《临床骨科杂志》2018年第3期263-265,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较后纵韧带骨化(OPLL)患者中颈椎标准位K线阴性而颈椎过伸位K线阳性者与标准位K线阳性者的手术疗效。方法采用后路单开门椎板成形术治疗73例OPLL患者。根据K线情况分为标准位K线阳性组(标准位K线阳性,41例)和过伸位K线阳性组(标准位K线阴性而颈椎过伸位K线阳性,32例)。采用JOA评分评价临床功能,并计算神经功能恢复率。结果患者均获得随访,时间18～36(23.8±5.5)个月。至末次随访,标准位K线阳性组JOA评分由术前9～13(11.4±1.7)分提高至11～17(14.8±3.6)分(P<0.001),恢复率为46.7%～85.1%(60.8%±18.6%);过伸位K线阳性组JOA评分由术前8～12(10.3±1.6)分提高至11～16(13.4±2.8)分(P<0.001),恢复率为36.2%～76.3%(49.1%±19.7%);两组JOA评分相似(P=0.087),但标准位K线阳性组神经功能恢复率高于过伸位K线阳性组(P=0.011)。结论对于OPLL标准位K线阴性而过伸位K线阳性患者,后路椎板成形术是一种安全有效的治疗方法,但标准位K线阳性OPLL患者术后神经功能改善优于过伸位K线阳性患者。Objective To compare the surgical outcomes of patients with ossification of the posterior longitudinal ligament（ OPLL） with negative K-line in the neck neutral position but positive K-line in extension radiograph with patients with OPLL with positive K-line in neutral radiograph. Methods The 73 patients with OPLL were treated by using single-door laminoplasty. There were 41 patients with positive K-line in neutral radiograph（ standard positive Kline group） and 32 patients with negative K-line in the neck neutral position but positive K-line in extension radiograph（ extension positive K-line group）. The clinical function was evaluated by using the JOA score and the recovery rate of neurological function was calculated. Results All of the 73 patients were followed up for 18 ～ 36（ 23. 8 ±5. 5） months. At final follow-up,the JOA score was improved from preoperative 9 ～ 13（ 11. 4 ± 1. 7） points to 11 ～17（ 14. 8 ± 3. 6）（ P〈0.001） in standard positive K-line group,the score was improved from preoperative 8 ～ 12（ 10. 3 ± 1. 6） to 11 ～ 16（ 13. 4 ± 2. 8） points（ P〈0.001） in extension positive K-line group; the JOA recovery rate was 46. 7% ～ 85. 1%（ 60. 8% ± 18. 6%） in standard positive K-line group and 36. 2% ～ 76. 3%（ 49. 1% ±19. 7%） in extension positive K-line group. There was no statistical difference between two groups in term of JOA score at final follow-up（ P = 0. 087）,but there was statistical difference between two groups in term of JOA recovery rate（ P = 0. 011）. Conclusions Laminoplasty is a safe and effective treatment procedure for OPLL with negative Kline in the neck neutral position but positive K-line in extension radiograph. However,the improvement of postoperative neurological function in patients with standard positive K-line OPLL is better than that of patients with negative Kline in the neck neutral position but positive K-line in extension radiograph.

关 键 词：颈椎 后纵韧带骨化 椎板成形术 K线 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]