后路单开门椎管成形术与全椎板切除减压术治疗颈椎后纵韧带骨化症的对比研究

A comparison of unilateral open-door cervical expansive laminoplasty and laminectomy for treatment of ossification of the posterior longitudinal ligament

[目的]探讨颈椎后路单开门微型钛板内固定椎管成形术与全椎板切除减压侧块螺钉内固术治疗颈椎后纵韧带骨化症的临床效果。[方法]入选80例颈椎后纵韧带骨化症患者,随机分为单开门组和全椎板切除组,实施减压内固定术。术后随访时间为12~24个月。从手术时间、术中失血量、颈椎曲度指数丢失度、脊髓后移距离、颈椎活动丢失角度、神经功能改善率及并发症等几个方面比较两组的临床效果。[结果]单开门组在手术时间、术中透视时间、术中出血量等方面明显少于全椎板切除组;在脊髓后移距离、颈椎曲度指数、颈椎活动丢失角度等方面少于全椎板切除组。两组在神经功能改善率及并发症发生率方面无显著差异。[结论]后路单开门钛板内固定椎管扩大成形术,手术操作简单,创伤小,疗效确切,可作为颈椎后纵韧带骨化症的首选术式。

[Objective] To explore and compare the effects of unilateral open-door cervical expansive laminoplasty and laminectomy in the treatment of ossification of the posterior longitudinal ligament（ OPLL）. [Methods] Eighty patients with OPLL were randomized to unilateral open-door cervical expansive laminoplasty plus mini titanium-plate fixation group and laminectomy plus lateral mass screw fixation group,and followed up for 12 ~ 24 months. Outcomes and complications of the two groups were compared. [Results] The outcomes of the laminoplasty group were better than that of the laminectomy group in the operation time,fluoroscopy time,and blood loss,but less in spinal movement distance,cervical curvature index,range of motion（ P〈0. 05）. There were no significant differences between the two groups in terms of JOA score and complications. [Conclusion] Unilateral open-door cervical expansive laminoplasty plus mini titanium-plate fixation is the first choice for OPLL,for its simple operation,smallerl trauma,and better curative effect.