术中超声联合K线在颈椎后纵韧带骨化症后路手术治疗中的应用

Intraoperative ultrasonography and K-line during posterior operation for ossification of the posterior longitudinal ligament in the cervical spine

目的探讨术中超声与MRI的K线在颈后路手术治疗颈椎后纵韧带骨化症(OPLL)中的应用。方法回顾性分析我科收治的84例OPLL患者的临床资料,均采用后路椎板切除减压内固定术,术前分为A组(K线阳性组)和B组(K线阴性组),术中超声所见分为分离型、接触型和压迫型,分别评估两组和三型JOA评分改善率,评价其指导意义。结果K线两组患者年龄、手术出血量、手术时间及术前JOA评分无显著差异(P>0.05),JOA评分改善率存在明显差异(P<0.05),术中超声压迫型JOA评分改善率较分离型、接触型差异均存在统计学意义(P<0.05)。结论证实了术中超声和K线可有效预测OPLL后路手术的疗效,而术中超声更优。

Objective To investigate intraoperative ultrasonography and K-line during posterior decompression with instrumented fusion for ossification of the posterior longitudinal ligament in the cervical spine.Methods Eighty-four cases with cervical OPLL, receiving Cervical vertebral posterior laminectomy and fusion, were retrospectively analyzed. All patients were classified into two groups according to their K-line relating to the range of OPLL, group A （ K-line positive） and group B （ K-line negative）. Intraoperative images by ultrasonography were classified into three types, compression type, separation type and contact type. JOA scores and recovery rates of JOA were respectively analysed in two groups and three types.Results No significances of baseline characteristics,including age, operative time, blood loss and JOA scores, in K-line two groups were observed before operation （ P 〉0.05）.Higher JOA scores and better recovery rates of JOA were observed in group A than group B after operation （ P 〈0.05）. Higher JOA scores and better recovery rates of JOA were observed in compression type than separation type and contact type after operation （ P 〈0.05）.Conclusion Intraoperative ultrasonography and K-line can effectively predict the curative effect of posterior operation of OPLL, and intraoperative ultrasonography better.