Objective To investigate the effects of posterior longitudinal ligament(PLL)reseection or reservation on cervical spondylotic myelopathy (CSM) in anterior cervical decompression surgery. Methods The clinical data of 62 cases which had been carried out anterior cervical decompression in the treatment of GSM were reviewed.and there were 37 cases PLL reserved in Group A and there were 25 cases PLL resection in Group B. The Japanese Orthopedic Association (JOAJ scoring system was used tor evaluation of clinical out come. Six months after surgery, JOA value, neurological function recovery rate and the sagittal diameter of dural sac were compared between two groups. Results Preoperatively,the JOA values were in the similar range between the two qroups. At 6 months after surgery,the JOA values of neurological function recover}' rate and the increment of sagittal diameter of dural sac were 15.35±0.38,76.3±20.5% and 3.68±1.45 mm in group B,respectively,which were all significantly higher than those in group A(14.20±0,25, 61.2±19.7%, 2.59±1.33 mm). Conclusions The decompression effect is more completely after resection of the PLL during anterior cervical decompression surgery and it can obtain better clinical effect than PLL reserved in the treatment of GSM.%目的 探讨保留与切除后纵韧带对颈前路手术治疗脊髓型颈椎病的疗效影响.方法 应用颈前路手术治疗脊髓型颈椎病(CSM)62 例,其中后纵韧带保留组(A 组)37 例,切除组(B 组)25例.据JOA 评分系统进行临床疗效评价,于术后6 个月比较两组JOA 评分提高程度、神经功能改善率和硬膜囊前后径的变化.结果 术前两者比较无统计性差异,术后6 个月A 组JOA 评分(14.20±0.25),神经功能改善率为(61.2±19.7)%,硬膜囊前后径增加值(2.59±1.33) mm,B 组JOA评分(15.35±0.38),神经功能改善率为(76.3±20.5)%,硬膜囊前后径增加值(3.68±1.45) mm,两组比较差异均有统计学意义(P<0.05).结论 颈椎前路减压术中切除后纵韧带使病变节段减压更彻底,其临床疗效优于保留后纵韧带.
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