摘要
[目的]观察伴脊髓高信号（high—signal intensity zone，HIZ）改变的颈椎后纵韧带骨化症（ossification of the posterior longitudinal ligament，OPLL）手术疗效结果，分析影响疗效的因素，为临床治疗选择提供依据。[方法]随访自2005年3月～2008年3月诊治于上海长征医院骨科的40例伴有脊髓HIZ改变的OPLL患者，其中19例行经前路手术为A组，21例行颈后路手术为P组。术前及术后末次随访时行JOA17评分法进行评分，分析比较术前术后评分并计算比较分析改善率。[结果]A组平均随访时间（19．5±3．4）个月，P组平均随访时间（20．3±4．5）个月，术后随访时间无统计学差异。A组术后JOA评分（12．8±0．9）分，P组（11．5±1．6）分，差异具有统计学意义。手术治疗改善率A组为（56．2±8．4）％，P组（52．5±12．2）％，差异不具有统计学意义。脊髓HIZ改变区域术后无一例完全消失，但范围均有一定程度减小。[结论]伴有HIZ改变的OPLL手术风险大，神经功能恢复有限，但是根据术者的经验、骨化组织类型、位置以及椎管狭窄率选择正确的前路或者后路手术方式均可达到良好的效果。
[Objective] To observe and analyze the clinical results of ossification of posterior longitudinal ligament （OPLL） combined with high-signal intensity zone （HIZ） change. [ Methods] Forty patients with OPLL combined with HIZ were treated from March 2004 to March 2008. Anterior approach surgery was given to 19 cases as group A and posterior approach surgery was given to 21 cases as group P. All cases were followed up. The pre - and post - operative JOA17 scores and improvement ratio were evaluated. [ Results ] The mean follow - up time were （ 19. 5 ＋ 3.4 ） months in group A and （ 20. 3± 4. 5 ） months in group P. The mean improvement ratio were （56. 2 ±8.4）% in group A and （52. 2± 12. 2）% in group P. There were no statistical differences between those of groups A and P. Mean JOA scores at last follow - up were （ 12. 8± 0. 9 ） in group A and （ 11.5± 1.6） in group P, with significantly difference. [ Conclusion] Treatment of OPLL combined with HIZ is a high risk procedure with limited recovery in neorn - function. Good surgical result could be got with correct judgement of type and location of OPLL, occupation ratio of spinal canal and selection of approach.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2010年第1期38-41,共4页
Orthopedic Journal of China
关键词
颈椎
后纵韧带骨化
脊髓高信号
减压
内固定
cervical spine
ossification of posterior longitudinal ligament
high - signal intensity zone
decompression
internal fixation
