摘要
目的:探讨后路Hybrid手术治疗混合型颈椎后纵韧带骨化症的临床效果。方法:回顾性分析本院2015年3月-2017年7月采用后路杂交(Hybrid)手术治疗的8例混合型颈椎后纵韧带骨化症患者的临床资料。记录患者的手术时间、术中出血量、固定节段、视觉模拟评分法(VAS)及日本骨科协会(JOA)神经功能评分及神经功能改善率(RIS)及并发症发生情况。结果:所有患者手术均顺利完成,手术时间118～182 min,平均142.88 min;术中出血量为250～400 mL,平均325.00 mL;术中无脊髓损伤或脑脊液漏等并发症发生,1例出现C5神经麻痹症状,术后予以激素及神经营养药物治疗2周后,症状消失。所有患者切口均甲级愈合,均获得随访,随访时间6～9个月,平均7个月。患者术前颈项部VAS评分为7～9分,末次随访VAS评分改善为0～2分。JOA评分也均有不同程度的改善,从术前的8～12分(平均10.25分),改善为末次随访的13～16分(平均15.13分)。神经功能改善率为44.44%～85.71%(平均72.13%),其中优5例,良2例,可1例。末次随访均未发现"再关门"情况。结论:颈椎后路Hybrid手术治疗混合型颈椎后纵韧带骨化症手术安全简单,并发症少,临床疗效满意。
Objective:To observe the clinical effect of posterior Hybrid technique in the treatment of cervical mixed type ossification of posterior longitudinal ligament.Method:The clinical data of 8 patients with mixed ossification of posterior longitudinal ligament of cervical spine treated by posterior Hybrid technique in our hospital from March 2015 to July 2017 were retrospectively analyzed.The operation time,intraoperative bleeding volume,fixed segment,visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)neurological function scores,neurological function improvement rate(RIS)and complications were recorded.Result:All patients were successfully operated,the operation time was ranging from 118 min to 182 min,the average was 142.88 min;the intraoperative bleeding volume was ranging from 250 to 400 mL,the average was 325.00 mL.No complications such as spinal cord injury or cerebrospinal fluid leakage occurred during operation.1 cases patient was complicated with C5 nerve paralysis symptoms,which alleviated after 2 weeks of hormone and neurotrophic therapy,the symptoms disappeared.All patients wound were healing best and followed up for 6 to 9 months,the average was 7 months.The preoperative VAS score of neck was ranging from 7 to 9 scores,and the last follow-up VAS score was improved by 0 to 2 scores.The JOA score improved to different degrees,which was improved from 8 to 12 scores(average 10.25 scores)before operation to 13 to 16 scores(average 15.13 scores)during the last follow-up.The neurological function improvement rate was ranging from 44.44%to 85.71%(average 72.13%),of which 5 cases were excellent,2 cases were good and 1 case was fair.No door-reclose was noted during the last follow-up.Conclusion:Cervical posterior Hybrid technique in the treatment of cervical mixed type ossification of posterior longitudinal ligament is safe and simple,with fewer complications and clinical effect is satisfactory.
作者
张力
陈宇
陈德玉
李洪瀚
李应国
林建聪
郑毅全
ZHANG Li;CHEN Yu;CHEN Deyu(Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 360002,China)
出处
《中国医学创新》
CAS
2019年第1期39-44,共6页
Medical Innovation of China
关键词
颈椎后纵韧带骨化症
混合型
Hybrid手术
后路
Cervical ossification of the posterior longitudinal ligament
Mixed type
Hybrid technique
Posterior
