后纵韧带切除在脊髓型颈椎病前路手术中的应用

The Resection of Posterior Longitudinal Ligament in the Anterior Cervical Operation of Cervical Spondylotic Myelopathy

目的 :探讨脊髓型颈椎病前路手术中行后纵韧带切除的指征、方法和注意事项。方法 :回顾性分析了自2 0 0 1年 1月～ 2 0 0 2年 6月在颈椎前路手术中行后纵韧带切除的 3 8例脊髓型颈椎病患者的临床资料和随访结果。结果 :3 0例获得随访 ,平均改善率为 72 .6% ,优 10例 ,占 3 3 .3 % ;良 12例 ,占 40 % ;中 6例 ,占 2 0 % ;差 2例 ,占 6.7%。结论 :对合并后纵韧带肥厚压迫颈髓或合并颈椎间盘脱出至硬膜外腔的脊髓型颈椎病患者行前路手术中 ,需切除后纵韧带 ,彻底减压 。

Objective:To discuss the indication,method and attention of the resection of posterior longitudinal ligament in anterior route cervical operation of cervical spondylotic myelopathy.Method:The resection of posterior longitudinal ligament was applied in 38 cases of cervical spondylotic myelopathy undergone anterior cervical operation from January 2000 to June 2002 and their clinical data and operative effect were reviewed.Result:Thirty cases were followed up.The mean recovery rate based on the scoring system of the Japanese Orthopaedic Association(JOA) was 72.6%.10 cases were excellent (33.3%),12 cases were good(40%),6 cases were fine(20%),2 cases were bad(6.7%).Conclusion:The satisfatory result and complete decompression can be obtained by resecting posterior longitudinal ligament in anterior route operation of cervical spondylotic myelopathy combined with the thick posterior longitudinal ligament compressing the cervical spinal cord and the epidural cervical disc extrusion.