OPLL后路单开门椎管扩大成形术后C_(5)神经根麻痹的风险  

Risk of C5 nerve root paralysis after OPLL posterior open-door enlarged spinal canal plasty

作　　者：商玉臣 杨敬 苏宝金 朱伟 何保华 王强 赵鹏 SHANG Yu-chen;YANG Jing;SU Bao-jin;ZHU Wei;HE Bao-hua;WANG Qiang;ZHAO Peng(Orthopedics Department of Emergency Management Department,Emergency General Hospital,Beijing 100028,China;Orthopedics Department of Zaoqiang County Traditional Chinese Medicine Hospital,Hebei Province,Hengshui 053100,China)

机构地区：[1]应急管理部应急总医院骨科,北京100028 [2]河北省枣强县中医医院骨科,河北衡水053100

出　　处：《颈腰痛杂志》2024年第3期496-498,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 探讨颈椎后纵韧带骨化症(OPLL)椎管占位严重程度与后路单开门椎管扩大成形术后C_(5)神经根麻痹的关系。方法 纳入2019年12月~2021年12月该院收治的88例OPLL患者,采用单开门椎管扩大成形术治疗,术后根据是否发生C_(5)神经根麻痹分组,比较两组术前椎管占位率以及性别、年龄、手术节段等临床资料,并采用多因素分析椎管占位率、C_(5)椎间孔宽度等与C_(5)神经根麻痹的关系。结果 88例OPLL患者术后19例发生C_(5)神经根麻痹;麻痹组与非麻痹组椎管占位率、C_(5)椎间孔宽度、术后脊髓漂移距离、手术节段数、年龄差异具有统计学意义(P<0.05);组间性别、OPLL类型差异无统计学意义(P>0.05);多因素分析显示,椎管占位率、C_(5)椎间孔宽度、脊髓漂移距离是术后C_(5)神经根麻痹的危险因素(P<0.05)。结论 OPLL单开门椎管扩大成形术后C_(5)神经根麻痹发生率较高,椎管占位率、C_(5)椎间孔宽度、脊髓漂移距离是危险因素之一。Objective To investigate the relationship between the severity of spinal canal space occupation and postoperative C_(5) nerve root palsy in ossification of the posterior longitudinal ligament(OPLL)of the cervical spine.Methods Eighty-eight OPLL patients in our hospital from December 2019 to December 2021 were included and treated with single-door laminoplasty.After surgery,they were divided into groups according to the occurrence of C_(5) nerve root palsy.The preoperative spinal canal space occupation rate,gender,age,surgical segment and other clinical data between the two groups were compared.Multivariate analysis was used to analyze the relationship between spinal canal space occupation rate,C_(5) intervertebral foramen width,and C_(5) nerve root palsy.Results Nineteen of 88 OPLL patients developed C_(5) nerve root palsy after operation.There were statistically significant differences in spinal canal space occupation rate,C_(5) intervertebral foramen width,postoperative spinal cord drift distance,number of surgical segments and age between the paralysis group and the non-paralysis group(P<0.05).There was no significant difference in gender and OPLL type between groups(P>0.05).Multivariate analysis showed that spinal canal space occupation rate,C_(5) intervertebral foramen width,and spinal cord drift distance were risk factors for postoperative C_(5) nerve root palsy(P<0.05).Conclusion The incidence of C_(5) nerve root palsy is high after OPLL single-door laminoplasty,and spinal canal space occupation rate,C_(5) intervertebral foramen width and spinal cord drift are the risk factors.

关 键 词：颈椎后纵韧带骨化症 单开门椎管扩大成形术 椎管占位 术后C_(5)神经根麻痹 

分 类 号：R619[医药卫生—外科学]