颈椎后路减压内固定治疗K线阳性后纵韧带骨化症

Posterior cervical decompression and internal fixation for the treatment of K-line positive OPLL

目的:探讨颈椎后路减压内固定治疗K线阳性后纵韧带骨化症(OPLL)的临床效果.方法:选取我院治疗的32例颈椎后纵韧带骨化症患者作为研究对象,依据后纵韧带骨化范围与K线(即中立位下颈椎C2至C7椎管中点的连线)的位置将所有患者分为两组,骨化范围超过K线位置的患者定义为阴性组,未超过K线位置患者定义为阳性组.评估两组患者术前及术后1年各项临床指标变化情况.结果:32例颈椎后纵韧带骨化症患者中,K线阳性22例,K线阴性10例,K线阳性组患者术后用日本骨科学会(JOA)评分系统的评分、神经功能改善率及颈椎曲度变化优于K线阴性组,差异具有统计学意义(P<0.05).结论:对于颈椎后纵韧带骨化症患者术前进行K线阴阳性评估,可预测患者术后预后情况,故K线作为评估预后的特异性指标,值得在临床推广应用.

Aim：To investigate the clinical effect of posterior cervical decompression and internal fixa- tion for K-line positive ossification of posterior longitudinal ligament（OPLL）. Methods： Thirty-two hos- pitalized OPLL patients were chosen as an object of study, according to OPLL range and the K-line position （ the midpoint connection line of C2 to C7 Spinal canal in neutral position） all patients were divided into two groups, patient with ossification range exceed K line position is defined as the negative group, ossification range does not exceed the K-line position is defined as the positive group. Patients were evaluated for the change of clinical indicators before surgery and 1 year follow up. Results： Thirty-two OPLL patients, K-line positive 22, K-line negative 10, postoperative JOA （ Japanese Orthopedic Association） score, neurological improvement rate and cervical curvature change of the K line positive group patients are better than those of K line negative, the difference is statistically significant （P 〈 0. 05 ）. Conclusion： The preoperative assessment with K-llne positive and negative for the ossification of posterior longitudinal ligament surgery patients, can predict the prognosis, so as a specific indicator of postoperative prognosis, the K-line assessment should be clinical application.