摘要
目的分析颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)患者椎管成形术后随访期间OPLL的CT影像学进展特征。方法回顾性分析2011年6月至2016年6月行颈椎后路单开门椎管成形术治疗21例OPLL患者的相关资料,男11例,女10例;年龄55-69岁,平均(61.48±4.29)岁。收集所有患者的性别,年龄,术前、术后及末次随访时日本矫形外科学会(Japanese Orthopaedic Association Scores,JOA)评分。通过术前及术后随访时的颈椎CT扫描及二维重建测量OPLL长度、宽度和厚度,计算平均进展速度,并分析术前OPLL大小与术后OPLL进展速度的关系。结果随访时间1.2-6.5年,平均(3.36±1.92)年。颈椎JOA评分手术前为(11.81±1.75)分,末次随访时为(14.43±1.69)分,差异有统计学意义(t=3.8,P<0.01)。术后OPLL的长度、宽度和厚度的平均进展速度分别为(3.54±2.89)mm/年、(0.49±0.52)mm/年和(0.34±0.21)mm/年。长度的平均进展速度与宽度、厚度比较,差异均有统计学意义(分别为t=3.6,P=0.003;t=3.8,P=0.002)。术后OPLL头端进展速度为(1.54±1.19)mm/年,尾端进展速度为(1.60±1.33)mm/年,两者差异无统计学意义(t=0.1,P=0.559)。线性回归分析显示OPLL长度进展速度与术前长度有相关性(OPLL长度进展速度(mm)=0.05×术前长度+1.23,R2=0.26,P=0.02);而OPLL宽度和厚度的进展速度与术前OPLL宽度和厚度无相关性。局灶型OPLL术后进展速度为(3.02±0.26)mm/年,节段型OPLL进展速度为(2.97±0.65)mm/年,连续型OPLL进展速度为(3.65±1.14)mm/年,混合型OPLL进展速度为(3.82±1.27)mm/年,其中任意两种类型OPLL术后进展速度的差异均无统计学意义。结论颈椎OPLL后路单开门椎管成形术后CT影像学随访显示OPLL长度、宽度和厚度均有进展,其中长度的进展速度较宽度和厚度更快,但OPLL头、尾端的进展速度无差异;OPLL长度的进展速度与术前OPLL长度呈正相关性。混合型及连续型OPLL的术后进展速度可�
ObjectiveTo evaluate the CT imaging after laminoplasty for the patients with ossification of the posterior lon-gitudinal ligament (OPLL) of the cervical spine. MethodsFrom June 2011 to June 2016, Retrospectively analyzed the data of OPLL patients who underwent posterior cervical open-door laminoplasty. There were 21 patients finally enrolled in this study, which consisted of 11 male and 10 female aging from 55-69, mean(61.48±4.29). The preoperative patients all had severe symp-toms of spinal compression. Collected the Japanese Orthopaedic Association Scores(JOA) Scores of all patients for gender, age, pre-operative and postoperative follow-up.The length, width and thickness of OPLL were measured by CT scan and two-dimensional re-construction of cervical spine during preoperative and follow-up, and the average progress rate was calculated. The relationship be-tween OPLL size before surgery and OPLL progress rate after surgery was analyzed.Results A total of 21 patients were included in this study, with an average age of 61.48±4.29 years-old. The mean follow-up time was 3.36±1.92 years. The JOA score of cervi-cal spine was 11.81±1.75 before operationand 14.43±1.69 at the last follow-up time (t=3.8, P<0.01). The progression rate of OPLL length, width and thickness was 3.54± 2.89 mm/year, 0.49± 0.52 mm/year and 0.34± 0.21 mm/year, respectively. Compared with the width and thickness, the average progress speed of the length was statistically significant (t=3.6, P=0.003;t= 3.8, P=0.002). The progression rate of the rostraland caudal of OPLL was 1.54 ±1.19 mm/year and 1.60±1.33 mm/year (t=0.1, P=0.559). Linear regression showed that OPLL length progression speed (mm)=0.05×preoperative length+1.23, R2=0.26 and P=0.02. Theprogres-sion rate of width and thickness of OPLL had no correlation with preoperative OPLL width and thickness. The progression rates of local, segmental, continuous, and mixed OPLL were 3.02±0.26 mm, 2.97±0.65 mm, 3.65±1.14 mm, and 3.82±1.27 mm per year.Conclusion The JOA score of the pos
作者
徐广宇
邹飞
姜建元
马晓生
夏新雷
吕飞舟
Xu Guangyu;Zou Fei;Jiang Jianyuan;Ma Xiaosheng;Xia Xinlei;Lyu Feizhou(Department of Orthopaedics, Huashan Hospital, Fudan University, Shanghai 200040, China;Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2018年第24期1530-1536,共7页
Chinese Journal of Orthopaedics
关键词
颈椎
后纵韧带骨化
体层摄影术
螺旋计算机
随访研究
Cervical vertebrae
Ossification of posterior longitudinal ligament
Tomography, spiral computed
Follow-up studies
