经后路椎管扩大减压术治疗多节段颈椎后纵韧带骨化症

Posterior Cervical Enlarged Laminectomy for Multi-segmental Ossification of the Posterior Longitudinal Ligament

研究经后路椎管扩大减压术治疗多节段颈椎后纵韧带骨化症的疗效。自2006年8月至2011年8月,采用经后路椎管扩大减压术治疗多节段颈椎后纵韧带骨化症27例,其中男19例,女8例,年龄48岁～82岁,平均63.6岁。手术前后用日本矫形外科学会(JOA)评分判断神经功能:用疼痛视觉模拟评分(VAS)评价颈肩痛程度。结果所有患者均获随访,随访时间为3个月～5年,平均18个月。术后JOA评分为13.3(10～17)分,较术前10.2(5～14)分有显著改善(t=14.72,P<0.01)。术后症状优良率88.9%。仅2例出现C5神经根麻痹,为一过性。术后颈肩痛VAS评分平均为1.9(1～3)分,较术前5.2(4～6)分明显缓解(t=14.25,P<0.01)。经后路椎管扩大减压术能使脊髓彻底减压,充分后移,避免C5神经根麻痹,是目前治疗该病的较好方法。

To study the results of posterior cervical enlarged laminectomy for multi--segmental ossification of the posterior longitudinal ligament, totally 27 patients with multi--segmengtal cervical OPLL treated by posterior cervical enlarged laminectomy from august 2006 to august 2011 were investigated. There were 19 males and 8 females,with an average age of 63.6 years （ranged,48-82 years）. JOA scoring system and the visual analogue scale （VAS） scoring were applied to evaluate the neurological function and neck/shoulder pain respectively. All cases were followed up for 3 months to 5 years （average 18 months ）. JOA score has improved from 10.2 （ 5± 14 ） preoperatively to 13.3 （ 10± 17 ） postoperatively（ t = 14.72, P 〈0.01）. The excellent and good rate was 88.9 %. The palsy of C5 nerve root occurred in only 2 patients, both recovered after surgery. The mean postoperative VAS score was 1.9 （ 1 ~ 3 ） , comparing with the preoperative score 5.2 （ 4 - 6 ）. The pain in neck/shoulder was alleviated obviously （t= 14.25 ,P〈0.01 ）. Posterior cervical enlarged laminectomy is an effec- tive method in treating multi--segmental cervical OPLL,in terms of significant posterior shift to the spinal cord, relief of cervical/shoulder pain,lower rate of the palsy of C5 nerve root.