颈椎前路椎体次全切除融合术治疗年轻型后纵韧带骨化继发脊髓型颈椎病1例并文献回顾  

Anterior cervical subtotal resection and fusion for the treatment of cervical spondylotic myelopathy secondary to young posterior longitudinal ligament ossification:a case report and literature review

作　　者：张念 陈在飞 刘燕 任潇 蔡旋 ZHANG Nian;CHEN Zaifei;LIU Yan;REN Xiao;CAI Xuan(School of Orthopedics and Traumatology,Guizhou University of Traditional Chinese Medicine,Guizhou Province,Guiyang 550000,China;Department of Orthopedics and Traumatology,Zunyi Hospital of Traditional Chinese Medicine,Guizhou Province,Zunyi 563000,China)

机构地区：[1]贵州中医药大学骨伤学院,贵州贵阳550000 [2]贵州省遵义市中医院骨伤科,贵州遵义563000

出　　处：《中国当代医药》2024年第25期155-159,168,共6页China Modern Medicine

基　　金：贵州省遵义市科技创新人才团队培养计划项目(遵市科人才〔2023〕7号)。

摘　　要：颈椎后纵韧带骨化症(OPLL)是指以颈椎后纵韧带异位骨化压迫脊髓、神经根而引起四肢无力、麻木、行走困难甚至瘫痪等神经症状为特点的一种颈椎退变性疾病,是导致脊髓压迫的重要原因之一。发病原因复杂、机制尚未明确。目前,尚无特效药物防止其骨化进展。对于合并脊髓型颈椎病(CSM)的患者,手术是最直接有效的方法。手术方式包括颈前路、颈后路和前后联合入路,究竟哪一种术式是最佳的治疗方法,仍存在较大争论。本文报道1例年轻型颈椎多节段OPLL继发CSM的患者,并探讨其病因、病机及手术入路的选择。患者主要表现为颈肩部疼痛伴右上肢无力,疼痛放射至右上肢,右上肢肌肉萎缩等。经最终讨论行颈椎前路椎体次全切除融合术(ACCF)治疗,术后患者恢复可,疗效满意,可为临床提供参考。Cervical posterior longitudinal ligament ossification(OPLL)refers to a degenerative disease of the cervical spine characterized by ectopic ossification of the posterior longitudinal ligament,which compresses the spinal cord and nerve roots,causing neurological symptoms such as limb weakness,numbness,difficulty walking,and even paralysis.It is one of the important causes of spinal cord compression.The cause of the disease is complex and the mechanism is not yet clear.At present,there is no specific drug to prevent the progression of ossification.Surgery is the most direct and effective method for patients with combined cervical spondylotic myelopathy(CSM).The surgical methods include anterior cervical approach,posterior cervical approach,and anterior posterior combined approach.There is still significant debate on which surgical approach is the best treatment method.This article reports a case of a young patient with multiple levels of OPLL of the cervical spine and secondary cervical spondylotic myelopathy(CSM),and explores its etiology,pathogenesis,and surgical approach selection.The patient's main symptoms include neck and shoulder pain accompanied by weakness in the right upper limb,pain radiating to the right upper limb,and muscle atrophy in the right upper limb.After the final discussion,anterior cervical corpectomy and fusion(ACCF)was performed,and the postoperative recovery of the patient was satisfactory.Therefore,the following report is provided as a reference for clinical practice.

关 键 词：后纵韧带骨化症 脊髓型颈椎病 年轻型 病因 病机 手术治疗 

分 类 号：R681.5[医药卫生—骨科学]