后路单开门颈椎管扩大椎板成形术治疗OPLL效果分析  

Effects of single-open-door cervical vertebrae on vertebroplasty for OPLL

作　　者：史锐[1] 朱振军[1] 杨永波[1] Shi Rui;Zhu Zhenjun;Yang Yongbo(Xinxiang Central Hospital,Xinxtiang 453000,Henan,China)

机构地区：[1]新乡市中心医院,河南新乡453000

出　　处：《临床心身疾病杂志》2020年第2期145-148,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨后路单开门颈椎管扩大椎板成形术治疗颈椎后纵韧带骨化症患者的临床效果.方法将200例颈椎后纵韧带骨化症患者,根据手术方法不同分为研究组与对照组,每组100例,分别予以后路单开门椎管扩大成形术及前路椎体次全切减压融合术,术后观察12个月.于术前及术后1个月、12个月采用日本矫形外科协会评分系统评定神经功能,采用视觉模拟疼痛评分法评定疼痛状况;比较两组颈椎矢状位参数、颈椎脊髓整体后移距离、脊髓前缘后移距离、脊髓膨胀度.结果(1)术后1个月、12个月两组日本矫形外科协会评分系统评分均显著高于术前(P<0.01),视觉模拟疼痛评分法评分均显著低于术前(P<0.01);术前及术后1个月、12个月两组日本矫形外科协会评分系统、视觉模拟疼痛评分法评分比较差异均无统计学意义(P>0.05).(2)术后12个月两组颈椎矢状面轴向距离均较术前显著增大(P<0.01);术前及术后12个月两组颈椎Cobb角、颈椎矢状面轴向距离比较差异均无统计学意义(P>0.05).(3)术后12个月研究组颈椎脊髓整体后移距离为(2.21±0.54)mm、脊髓前缘后移距离为(1.85±0.37)mm,脊髓膨胀度测定值显著大于对照组(P<0.01).结论后路单开门颈椎管扩大椎板成形术治疗颈椎后纵韧带骨化症患者临床效果显著,对患者的颈椎脊髓整体后移距离、脊髓前缘后移距离、脊髓膨胀度的改善作用显著优于前路椎体次全切减压融合术.Objective To explore the clinical effect of single-open-door cervical vertebrae on vertebroplasty for OPLL.Methods 200 patients with OPLL were enrolled in this study and were divided into the study group and the control group according to the surgical method.The posterior single-opening spinal canal angioplasty and anterior vertebral subtotal decompression and fusion were performed separately,and the observation was performed for 12 months.The JOA scoring system was used to assess neurological function before and 1 month and 12 months after operation,and the pain status was evaluated using VAS.The two groups of cervical sagittal parameters,PCS,PAS and ESC were compared.Results(1)The JOA scoring system scores of the two groups at 1 and 12 months after surgery were significantly higher than those before surgery(P<0.01),and the VAS scores were significantly lower than those before surgery(P<0.01).There was no significant difference in JOA scoring system and VAS score between the two groups before and 1 month and 12 months after operation(P>0.05).(2)At 12 months after surgery,the axial distance of the sagittal plane of both groups was significantly increased compared with that before operation(P<0.01).There was no significant difference in the Cobb angle and the axial distance of the cervical sagittal plane between the two groups before and 12 months after surgery(P>0.05).(3)After 12 months,the PCS in the study group was(2.21士0.54)mm and the PAS was(1.85±0.37)mm.The ESC measurement value was significantly larger than that in the control group(P<0.01).Conclusions The clinical effect of open-door cervical vertebral canal enlargement laminoplasty in the treatment of OPLL patients is significant,and the effect of PCS,PAS and ESC on patients after operation is more obvious than that of anterior vertebral subtotal resection.

关 键 词：颈椎后纵韧带骨化症 后路单开门椎管扩大成形术 前路椎体次全切减压融合术 脊髓整体后移距离 脊髓前缘后移距离 脊髓膨胀度 

分 类 号：R686.5[医药卫生—骨科学]