选择性椎板成形术治疗脊髓型颈椎病合并后纵韧带骨化症的效果观察

Observation of therapeutic effect of selective laminoplasty on cervical spondylotic myelopathy complicated by ossification of posterior longitudinal ligament

目的探讨选择性椎板成形术治疗脊髓型颈椎病合并后纵韧带骨化症的临床效果。方法队列研究。抽取2014年2月至2022年4月漯河医学高等专科学校第二附属医院收治的86例脊髓型颈椎病合并后纵韧带骨化症患者,按随机数字表法分为对照组和观察组,每组43例。对照组行传统椎板形成术,观察组使行选择性椎板成形术,比较两组患者的手术指标、脊髓功能、疼痛程度、颈椎活动度、颈椎曲度及并发症发生情况。结果手术过程中,观察组的手术时间、术中出血量、住院时间少于对照组,差异有统计学意义(P<0.05);术后1个月、6个月、1年,观察组日本骨科协会评分高于对照组,视觉模拟评分法评分低于对照组(P<0.05);术后,观察组颈椎活动度及曲度均高于对照组(P均<0.05);观察组并发症发生率低于对照组(P<0.05)。结论脊髓型颈椎病合并后纵韧带骨化症患者使用选择性椎板成形术治疗可以明显降低患者的疼痛程度以及并发症发生率,改善脊髓功能。

Objective To investigate the therapeutic effect of selective laminoplasty on patients with cervical spondylotic myelopathy complicated by ossification of posterior longitudinal ligament.Methods This study was a cohort trail.Eighty-six patients with cervical spondylotic myelopathy complicated by ossification of posterior longitudinal ligament admitted to the Second Affiliated Hospital of Luohe Medical College from February 2014 to April 2022 were selected.And they were divided into a control group and an observation group by random number table method,with 43 cases in each group.The control group underwent traditional laminoplasty,while the observation group was treated by selective laminoplasty.The surgical indicators,spinal cord function,pain level,range of cervical motion,cervical curvature,and incidence of complications were compared between the two groups.Results During the surgery,the observation group had shorter surgical time,lower intraoperative blood loss,and shorter hospital stay compared with the control group(P<0.05).The observation group had higher Japanese Orthopaedic Association score and lower visual analogue scale scores compared with the control group 1 month,6 months and 1 year after surgery(P<0.05).After surgery,the range of cervical motion and cervical curvature in the observation group were higher than those in the control group(both P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusions Selective laminoplasty,in the treatment of cervical spondylotic myelopathy complicated by ossification of posterior longitudinal ligament,can significantly reduce the degree of pain and incidence of complications,and improve spinal cord function.