多节段脊髓型颈椎病与颈椎后纵韧带骨化症单开门椎管成形术疗效分析

Curative effect analysis of single door treatment of multiple segmental cervical spondy1otic myelopathy and ossification of the posterior longitudinal ligament

目的分析多节段脊髓型颈椎病(CSM)和颈椎后纵韧带骨化症(OPLL)采用颈后路单开门椎管成形术治疗的临床疗效。方法回顾性分析采用颈后路单开门椎管成形结合微型钛板内固定术治疗的多节段CSM(CSM组)及节段性OPLL(OPLL组)共116例的临床资料,比较2组手术时间、手术失血量、手术并发症、神经功能改善情况及颈椎活动度的变化等。结果术中失血量、手术时间及手术并发症比较,差异无统计学意义(P>0.05);OPLL组神经功能改善率要低于CSM组,差异有统计学意义(P<0.05)。结论后路单开门椎管成形术可有效地治疗CSM及OPLL,术中失血量、手术时间以、颈椎活动度丢失及并发症发生率无明显差异,但OPLL患者神经功能改善情况低于CSM患者。

Objective To compare the clinical efficacy of cervical single door for multiple segmental cervical spondylotic myelopathy（ CSM）and ossification of the posterior longitudinal ligament（ OPLL）. Methods The clinical data of 116 patients with single door treatment of multiple segmental cervical spondy1 otic myelopathy and ossification of the posterior longitudinal ligament were studied retrospectively. The operation time,blood loss in operation,Surgical complications,neurological function improvement and the change of range of motion were compared. Results Intraoperative blood loss,operating time and complications of the two groups were compared,there was no statistically significant difference（ P〉0.05）;The recovery rate of JOA scores in OPLL group was significant lower than that in CSM group,the difference was statistically significant（ P〈0.05）. Conclusion Laminoplasty is an efective procedure for the treatment of patients due to either CSM or OPLL. However,recovery of neurological function of patients with OPLL was less than that ofpatients with CSM. There is no significant difference in intraoperative blood loss,operative time,loss of cervical range of motion and complications between the two groups.