前路手术治疗合并后纵韧带骨化的颈椎病的疗效分析

摘要

目的：探讨颈椎病合并后纵韧带骨化采用前路减压手术治疗的临床疗效。方法回顾分析本科收治的23例颈椎椎管狭窄程度<50%且合并后纵韧带骨化的颈椎病患者的临床资料。患者均采用颈椎前路椎体次全切钛网植骨钛板内固定术，比较手术前后JOA评分改变情况。结果23例患者均得到随访，术后随访12~51个月，平均27.6个月，固定节段均获得骨性融合，内固定物无松动、断裂。手术前、术后6月JOA及末次随访JOA评分分别为(8.16±2.18)、(12.48±3.46)、(13.25±2.06)分，手术前后JOA评分差异均有统计学意义(P<0.05)。结论颈前路手术治疗颈椎椎管狭窄程度<50%且合并后纵韧带骨化的颈椎病，可以获得彻底的椎管减压和满意的临床效果。%Objective To investigate the clinical outcome of anterior cervical decompression in the treatment of cervi-cal spondylotic myelopathy with ossification of the posterior longitudinal ligament. Methods 23 cases with cervical spondy-lotic myelopathy and ossification of the posterior longitudinal ligament were treated with anterior cervical decompression using titanium mesh and plate,of which the cervical canal narrow rate was less than 50%. The JOA scores were assessed before op-eration and in 6 and final follow-up after operation,the improvement rate of nerve function was analyzed in 6 and final follow-up postoperatively. Results 23 cases were followed up for 12 ~ 51 months (averaged 27. 6 months),The JOA scores were improved from (8. 16 ± 2. 18) preoperatively to (12. 48 ± 3. 46) and (13. 25 ± 2. 06) in 6 months and final follow-up after operation,and the difference was all statistically significant(P<0. 01). All the patients had bone graft fusion after 6 months postoperation. Conclusions Anterior cervical decompression is an effective treatment for cervical spondylotic myelopathy with ossification of the posterior longitudinal ligament,of which the cervical canal narrow rate was less than 50%.