应用单开门椎板成形术治疗颈椎后纵韧带骨化症

Cervical Ossification of Posterior Longitudinal Ligament Treated by Expansive Open Door Laminoplasty

目的 探讨颈椎后纵韧带骨化症的适宜手术入路及方式。方法 观察及分析应用单开门椎板成形术治疗颈椎后纵韧带骨化症302 例的近期与1 ～9 年远期临床疗效并将手术前、后X 线片、CT 及MRI等影像学资料进行对比。结果 302 例后纵韧带骨化症手术近期及远期神经功能评分显著提高,平均改善率分别为46 % 和68 % ,手术后X 线片显示颈椎管矢径显著增加,CT 示椎管截面积显著扩大,而MRI则显示脊髓向后移行,前后方压迫均解除。结论 单开门椎板成形术可通过扩大颈椎管空间使脊髓获充分减压。

Objective To discuss suitable surgical approaches and techniques for treating the ossification of posterior longitudinal ligament (OPLL) of cervical spine. Methods 302 cases with OPLL treated by expansive open door laminoplasty were reviewed and analysed. Some relevant imaging examination data, which were taken pre or post operatively, including plain X-ray film, CT scan and MRI were compared. Results The neurological function score of 302 cases increased obviously after operation and the mean rate of improvement of 46%was obtained 2-3 weeks after surgery and a mean rate of improvement of 68%was found at 1-9 years later. Plain X-ray film showed the increase of sagittal diameter of cervical spinal canal and CT scan showed the enlargement of cervical spinal canal while MRI showed the backward movement and decompression of spinal cord. Conclusion Both enlargement of cervical spinal canal and decompression of spinal cord can be obtained by expansive open door laminoplasty. Clinical result was satisfactory following the above mentioned procedure.