颈椎后路加前路巨大骨化物切除减压术

Anterior resection of the large ossifics mass in cervical canal after posterior laminectomy

目的 探讨颈椎后路加前路手术在巨大骨性致压物切除中的应用价值和注意事项。方法 对 12例先经后路扩大椎管再经前路直接切除巨大骨化物患者的临床资料及手术治疗结果 ,进行了回顾性分析。结果 术后随访 3.4年 (3个月～ 10年 ) ,JOA评分提高 5分 (1～ 7分 ) ,优 6例 ,良 5例 ,差 1例 ,疗效持久。结论 局限性巨大骨化物单纯行后路减压疗效不持久 ;先行后路椎管扩大为前路手术提供了安全余地 ,使前路直接切除骨化物成为可能 ;术中应扩大显露 ,仔细操作。

Objective To assess the efficacy and results of direct anterior resection of the large ossifics mass. Methods The resection of large ossifics mass by anterior approach after laminoplasty was applied to 12 patients. Their clinical data and surgical results were reviewed. Results The mean follow-up period was 3.4 years (range 3 months to 10 years). The average score of improvement according to JOA was from 1 to 7 with an average of 5.Of these, 6 cases were graded as excellent, 5 were good and 1 was poor. The operative effect was durable. Conclusion The effect of posterior decompression only was not durable for patients with large ossifics mass in cervical canal. It was safe and possible to resect the large ossifics mass anteriorly after laminectomy. The satisfied results could be obtained by sufficient exposure and careful manipulation.