漂浮骨化灶脊髓减压在颈椎后纵韧带骨化症治疗中的应用

Application of Floating Ossification and Spinal Cord Decompression for Ossification of Cervical Posterior Longitudinal Ligament

目的:探讨漂浮骨化灶脊髓减压治疗颈椎后纵韧带骨化症(OPLL)的手术疗效。方法:本组将2001年以来手术治疗的10例OPLL患者的临床资料作回顾性总结,其中5例行漂浮骨化灶脊髓减压。按照JOA评分标准判定其术后改善率。结果:漂浮骨化灶脊髓减压手术平均改善率为63%,直接切除骨化灶平均改善率为65%。前路直接切除骨化灶并发脑脊液漏1例,本组1例术前MR I检查存在脊髓信号改变者术后仍存在,无死亡及瘫痪加重病例。结论:漂浮骨化灶脊髓减压与直接切除骨化灶脊髓减压平均改善率无显著差异,前者可避免脊髓及硬膜囊损伤,减少临床并发症的发生。

Objective： To discuss surgical curative efficacy of floating ossification and spinal cord decompression for ossification of posterior longitudinal ligament （OPLL）. Methods： The clinic data of 10 patients from 2001 with cervical OPLL were reviewed and analyzed , five of them were decompressed from floating ossification and spinal cord decompression approach. The improvement rates according to JOA scoring systerm were evaluated. Results：The mean postoperative improvement rate was 63% in patients treated by floating ossification spinal cord decompression and 65% in those treated by direct resection of ossification. There was 1 patient with dural tear after anterior direct resection of ossification, and 1 patients had abnormal signal in spinal cord that was measured by preoperative MRI still occurrence post- operatively. No death and palsy aggravation. Conclusion： There is no significant deviation between floating ossification spinal cord decompression and direct resection of ossification, but the former may avoid the injury of spinal cord and dura mater, and to decrease clinic complication.