保留C7棘突单开门微型钛板固定椎管成形术治疗颈椎后纵韧带骨化症的疗效分析

Clinical outcome of preserving C7 spinous process cervical laminoplasty combined with titanium plate fixation in the treatment of ossification of the posterior longitudinal ligament

目的:观察保留C7棘突的单开门微型钛板固定椎管扩大成形术治疗颈椎后纵韧带骨化症的临床效果。方法:2009年10月至2011年12月25例颈椎后纵韧带骨化症患者在我院接受保留C7棘突单开门微型钛板固定椎管扩大成形术治疗,并获得完整随访。术后观察患者颈椎曲度指数、神经功能恢复及并发症发生情况。结果:所有手术均未出现脊髓及神经损伤等情况,随访期内未出现内固定物松动、脱出及"再关门"现象。颈椎曲度指数较术前丢失(2.3±0.7)%,神经功能改善率为(62.1±18.5)%,差异有统计学意义(P<0.05)。术后3个月时5例患者有明显轴性症状,经药物治疗后症状减轻。结论:保留C7棘突的单开门微型钛板固定椎管扩大成形术除可明显改善颈椎后纵韧带骨化症患者的神经功能,还能有效降低术后轴性症状的发生,临床疗效满意。

Objective： To investigate the clinical effects of preserving C 7 spinous process cervical laminoplasty combined with titanium plate fixation in the treatment of ossification of the posterior longitudinal ligament （ OPLL） . Methods：From October 2009 to December 2011, 25 cases of OPLL patients accepted the procedure of preserving C7 spinous process cervical laminoplasty combined with titanium plate fixation .The postoperative neurological recovery, cervical curvature index （ CCI） and complications were recorded and analyzed .Results：No spinal cord and nerves injury occurred during the operation .The Japanese Orthopedic Association （ JOA） scale was improved form （8.8 ±2.3） preoperatively to the （13.2 ±3.2） three months after surgery , and （13.9 ±3.5） at the final follow up , with a neurological recovery rate of （ 62.1 ±18.5 ）%（ P〈0.05 ） .The loss of CCI was just （ 2.3 ± 0.7）%, and the incidence of axial symptoms was 20%.During the follow up , there was no mini-plate loose, prolapse and the “closed” phenomeon encountered . Conclusion： Preserving C7 spinous process cervical laminoplasty combined with titanium plate fixation can improve the neurological function effectively for cervical OPLL patients .Moreover , it has a lower axial symptoms than the traditional laminoplasty .