重度颈椎后纵韧带骨化症后路单开门椎板成形术近期临床疗效  

Short-term clinical efficacy of posterior cervical unilateral open-door laminoplasty for severe ossification of posterior longitudinal ligament

作　　者：关凯 王飞[1] 高伟涛 李朋斌 杨建祥 周铁仁 GUAN Kai;WANG Fei;GAO Weitao;LI Pengbin;YANG Jianxiang;ZHOU Tieren(Department of Orthopaedics,Seventh Medical Center,PLA General Hospital,Beijing 100700;Department of Orthopaedics,Langfang Traditional Chinese Medicine Hospital,Langfang 065000;Department of Orthopaedics,Bazhou No.2 Hospital,Langfang 065701)

机构地区：[1]解放军总医院第七医学中心骨科,北京100700 [2]廊坊市中医院骨科,廊坊065000 [3]廊坊霸州市第二医院骨科,廊坊065701

出　　处：《颈腰痛杂志》2025年第1期154-157,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨后路单开门椎板成形术治疗重度颈椎后纵韧带骨化症的近期临床疗效。方法回顾性分析2018年5月至2021年5月接受颈椎后路单开门椎板成形术治疗的重度颈椎后纵韧带骨化症患者23例,其中17例资料完整并获得6个月以上随访纳入本研究,患者术前均行X线片、CT和MRI检查并进行分型和影像学测量,记录术前及末次随访时按日本骨科协会评分(JOA)并计算改善率,评估患者满意度,记录并发症。结果根据后纵韧带骨化(OPLL)形态学分型:连续型12例,局部型1例,间断型2例,混合型2例。术前椎管侵占率为(67±0.09)%;椎管侵占面积为(40±0.10)%,颈椎K线阳性(+)15例,阴性(-)2例。神经功能改善率平均43.3%,优3例,良3例,可11例,差0例。术后脑脊液漏1例,颈5神经根麻痹2例,切口延迟愈合1例。结论重度颈椎OPLL的患者应该个性化选择手术方案,后路单开门椎板成形术是治疗重度颈椎OPLL安全、有效的手术方式之一,近期临床效果满意。Objective To investigate the short-term clinical efficacy of posterior cervical unilateral open-door laminoplasty for severe ossification of posterior longitudinal ligament(OPLL).Methods From May 2018 to May 2021,23 cases with severe ossification of the posterior longitudinal ligament undergoing unilateral open-door laminoplasty were retrospectively reviewed,17 cases with complete data and more than 6 months follow-up were included in this study.All patients underwent preoperative X-ray,CT and MRI examinations and imaging measurements.Japanese Orthopaedic Association scores(JOA)were recorded preoperatively and at last follow-up,improvement rates were calculated,satisfaction rate was assessed,and complications were recorded.Results According to the morphological classification of cervical OPLL:12 continuous type,1 local type,2 intermittent type and 2 mixed type were included.The average preoperative spinal canal invasion rate and spinal canal area occupation rate were(67±0.09)%and(40±0.10)%respectively.15 cases were K line positive,and 2 were negative.The average neurological improvement rate was 43.3%,with excellent in 3 cases,good in 3 cases,and fair in 11 cases.There was 1 case with postoperative cerebrospinal fluid leakage,2 cases with C 5 nerve root palsy,1 case with delayed incision healing.Conclusion Patients with severe cervical OPLL should choose a personalized surgical plan according to the specific situation.Posterior unilateral open-door laminoplasty is a safe and effective surgical method for the treatment of severe cervical OPLL.The short-term clinical results are satisfactory.

关 键 词：颈椎 后纵韧带骨化 后路 椎板成型 重度 单开门手术 

分 类 号：R681.5[医药卫生—骨科学]