后路单开门结合侧块螺钉治疗颈椎后纵韧带骨化疗效分析

Analysis of Posterior Approach Opening-door Laminoplasty and Lateral Mass Screw in Treatment of Ossification of Posterior Longitudinal Ligament

目的分析后路单开门椎管扩大成形并使用侧块螺钉内固定治疗颈椎多阶段后纵韧带骨化的疗效及并发症。方法回顾性分析该院2011年12月—2017年1月治疗多阶段后纵韧带骨化52例患者资料,采用日本骨科协会(JOA)评分评价神经功能。患者均采用后路单开门减压、颈椎侧块螺钉固定手术。结果 JOA评分改善率平均72.5%(20.2%~90.4%),术后2例伤口形成血肿,1例肩背部疼痛,未发生脑脊液漏,未见深部感染、神经功能恶化、椎动脉损伤、内固定失败等严重并发症。结论颈椎单开门后路减压侧块镙钉固定术治疗颈椎后纵韧带骨化症能使椎管前后方充分减压,对脊髓干扰小、安全性高,又能恢复颈椎生理曲度,一次手术达到前、后方两次手术的目的 ,治疗效果满意。

Objective To analyze the curative effect and complications of posterior approach opening-door laminoplasty and lateral mass screw in treatment of ossification of posterior longitudinal ligament. Methods 52 cases of patients with longitudinal ligament after multiple phases of treatment in our hospital from December 2011 to January 2017 were selected and the nerve function was evaluated by the JOA, and the patients were treated with posterior approach opening-door laminoplasty and lateral mass screw for internal fixation surgery. Results The average improvement rate of JOA score was 72.5%(20.2%~90.4%), and three were 2 cases with hematoma and 1 case with shoulder and back pain, and there was no leakage of cerebrospinal, deep infection, nerve function deterioration, vertebral artery injuries and internal fixation failure. Conclusion The posterior approach opening-door laminoplasty and lateral mass screw in treatment of ossification of posterior longitudinal ligament can make the canalis vertebralis be fully compressed with small spinal cord interfere and high safety, and can recover the cervical vertebra alignment and reach the anterior and posterior operations goals by one time with satisfactory treatment effect.