多节段严重型颈椎后纵韧带骨化症的前路手术治疗分析

Surgical treatment of multisegmental severe ossification of posterior longitudinal ligament of cervical spine

目的:探究分析多节段严重型颈椎后纵韧带骨化症的前路手术治疗。方法:择取多节段严重型颈椎后纵韧带骨化症患者88例为研究对象,所有患者均行前路手术治疗,术后一段时间后随访,观察是否存在并发症,判断愈合与神经功能恢复情况,再对比治疗前后患者的生活质量情况。结果:经过治疗后,88例患者中,共有2例患者出现硬脊膜损伤,给予有效修补后,未发生脑脊液漏的情况。术后1例患者出现得C5神经根短暂性麻痹,术后3个月后,完全缓解,未发生患者出现脊髓损伤症状加重和椎动脉损伤。术后复查88例患者均骨性愈合,无异常现象。患者JOA评分及生活质量评分均优于治疗前(P <0. 05)。患者JOA评分中优44例,良33例,好转11例,优良率为87. 5%。结论:多节段严重型颈椎后纵韧带骨化症的前路手术治疗效果理想,可实现减压、治疗的目的,具有良好的安全性,术后并发症几率低,治疗效果好,能改善患者生活质量,可推广。

Objective Analysis of anterior surgical treatment for multisegnlental severe ossification of posterior longitudinal ligament of cervical spine. Method 88 patients with ossification of the multiple segment of the cervical posterior longitudinal ligament were selected as research object. All the patients were treated by anterior surgery. After a period of time after the operation, the complications were observed, the healing and the recovery of nerve function were judged, and the quality of life of the patients before and after treatment were compared. Results After treatment,2 out of 88 patients had spinal dura mater injury, and there was no cerebrospinal fluid leakage after effective repair. After the operation, 1 patients had transient paralysis of the C5 nerve root. After 3 months, the patients were completely relieved, and the symptonls of spinal cord injury and vertebral artery injury were not found in the patients. After operation,all 88 patients were healed without any abnormalities. The JOA score and quality of life score of patients were better than those before treatment （P 〈 0. 05）. In the JOA score,44 cases were excellent, 33 cases were good, and 11 cases improved, the excellent and good rate was 87. 5 %. Conclusion The anterior approach operation of the multisegmental severe cervical posterior longitudinal ligament ossification is ideal. It can achieve the purpose of decompression and treatment. It has good safety, low postoperative complications and good treatment effect. It can improve the quality of life of the patients and can be popularized.