单开门联合椎弓根钉治疗颈椎OPLL的效果  

Effect of single open-door combined with pedicle screw in the treatment of cervical OPLL

作　　者：田永刚[1] 张继东[2] 刘智[1] 韩立强[1] 福嘉欣[1] 郭树章 TIAN Yong-gang;ZHANG Ji-dong;LIU Zhi;HAN Li-qiang;FU Jia-xin;GUO Shu-zhang(Department of Orthopaedics,Tianjin Third Central Hospital,Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases,Artificial Cell Engineering Technology Research Center,Tianjin Institute of Hepatobiliary Disease,Tianjin 300170,China;Department of Spine Surgery,Tianjin Hospital)

机构地区：[1]天津市第三中心医院骨科,天津市重症疾病体外生命支持重点实验室,天津市人工细胞工程技术研究中心,天津市肝胆疾病研究所,天津300170 [2]天津医院脊柱外科

出　　处：《中国城乡企业卫生》2022年第3期1-5,共5页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的探讨单开门椎板成形术联合颈椎椎弓根钉内固定术治疗颈椎后纵韧带骨化症(OPLL)的临床疗效。方法回顾性分析2017年1月—2018年12月在天津市第三中心医院骨科因颈椎OPLL接受颈椎后路单开门椎板成形术联合颈椎椎弓根钉内固定术治疗,并获得随访的23例患者的临床资料。记录手术时间、术中出血量、并发症及椎弓根螺钉位置,比较术前和术后2个月、6个月、1年、2年JOA评分及颈椎C_(3-7)Cobb角。结果所有患者均顺利完成手术,无C_(3-7)神经根麻痹,无神经及椎动脉损伤,无切口感染。术后2个月、6个月、1年、2年JOA评分较术前均升高,差异均有统计学意义(P<0.01),而术后6个月、1年及2年差异无统计学意义(P>0.05)。术后C_(3-7)Cobb角较术前减小,差异均有统计学意义(P<0.01),但在各随访时间点Cobb角差异无统计学意义(P>0.05)。结论单开门椎板成形术联合颈椎椎弓根钉内固定术治疗颈椎OPLL能有效改善神经功能,同时稳定颈椎,有利于防止因颈椎曲度下降及后纵韧带骨化进展引起的神经功能恶化,值得临床推广应用。Objective To investigate the clinical effect of single open-door laminoplasty combined with cervical pedicle screw internal fixation in the treatment of cervical ossification of posterior longitudinal ligament (OPLL).Methods From January 2017 to December 2018,the clinical data of 23 patients with cervical OPLL who received single open-door laminoplasty combined with cervical pedicle screw internal fixation and were followed-up in Department of Orthopaedics of Tianjin Third Central Hospital were retrospectively analyzed.The operation time,intraoperative blood loss,complications and pedicle screw position were recorded.Japanese Orthopaedic Association (JOA)scores and C_(3-7)Cobb angle of cervical spine were compared between pre-operation and 1 month,6 months,1 year,2 years after operation.Results All patients completed the operation successfully without C_(3-7)nerve root paralysis,nerve and vertebral artery injury,and incision infection.The JOA scores 2 months,6 months,1 year and 2 years after operation were significantly higher than that before operation,and the differences were statistically significant (P<0.01),but there were no significant difference between 6 months,1 year and 2 years after operation (P>0.05).The Cobb angles of C_(3-7)2 months,6 months,1 year and 2 years after operation were significantly lower than that before operation,and the differences were statistically significant (P<0.01),but there were no significant difference in Cobb angle at each follow-up time point (P>0.05).Conclusion Single open-door laminoplasty combined with cervical pedicle screw internal fixation in the treatment of cervical OPLL could effectively improve neural function and stabilize cervical spine.It was beneficial to preventing the deterioration of neural function caused by decrease of cervical curvature and progress o ossification of posterior longitudinal ligament.It was worthy of clinical promotion and application.

关 键 词：颈椎 后纵韧带骨化 单开门椎板成形术 颈椎椎弓根钉内固定术 

分 类 号：R681.55[医药卫生—骨科学]