颈椎后纵韧带骨化症手术治疗27例疗效分析.pdfVIP

颈椎后纵韧带骨化症手术治疗27例疗效分析 中文摘要 [目的]探讨颈椎后纵韧带骨化症(OPLL)手术治疗方法、疗效及其并发症。 [方法]将自2007年3月起至2012年9月期间手术治疗的27例OPLL患者进随访，其中 前路手术12例，后路手术9例，后前路手术6例，随访6个月到3年，并在不同时间 点按JOA评分标准判定其术后改善率，并进行疗效评价。对患者术前术后X线、CT 及MRI影像学资料进行比较分析，并统计手术并发症。 [结果]27例患者2年后平均JOA评分由术前的（8.8±1.5）分提高至（13.6±1.0）， 平均改善率为57.3%。其中前路组为61.0%，后路组为52.3%，后前路组为62.4%； 术后1年末疗效评价：优1例，良15例，可10例，差0例。术后并发脑脊液漏2例， 节段性神经根麻痹1例，切口延迟愈合2例。 [结论]颈椎椎体减压融合手术方式治疗OPLL疗效确切，短期随访效果满意。其中 前路和后前路手术比单纯后路手术的术后改善率高。 关键词：颈椎； 后纵韧带骨化症； 手术治疗。 1 Curative effect analysis in Surgical treatment of ossification of posterior longitudinal ligament of cervical spine in 27 cases Abstract [Objective]To discuss surgical approaches, results and complications of ossification of posterior longitudinal ligament(OPLL)of cervical spine. [Method]The clinic data of 27 patients with cervical OPLL who were operated from Mar. 2007 to Sep. 2012 was followed up. Twelve cases were in anterior approaches, nine cases in posterior approaches, six cases in combined anterior-posterior approaches. The improvement rate according to the JOA scoring system was evaluated at each time point, then evaluated the curative effect. some relevant imaging examination data including X-rays, CT and MRI were also measured, which were taken pre-and post-operatively. Surgical complications were also recorded ． [Result]The average JOA score for the 27 cases increased from (8.8±1.5) preoperatively to (13.6±1.0) 2 years postoperatively. The average postoperative improvement rate was 57.3% in total, 61.0% in anterior group, 52.3% in posterior group and 62.4% in combined anterior-posterior group. And then the curative effect 1 year postoperatively was showed: exellent in 1 c