后路减压侧块镙钉固定治疗颈椎后纵韧带钙化症

目的 探讨应用后路减压,侧块镙钉固定治疗颈椎后纵韧带骨化症的临床疗效.方法 后路减压,Vertex侧块镙钉固定,恢复颈椎生理曲度,植骨融合术,共治疗26例后纵韧带钙化症患者,其中上颈段5例,下颈段21例;1个节段2例,2个节段4例,3个节段11例,4个节段5例,5个节段4例.结果 26例病人随访3～18个月,JOA评分由术前的平均3.4分提高到7.6分.椎管减压满意,颈椎生理曲度恢复良好,内固定无松动.结论 后路减压,侧块镙钉固定,恢复颈椎生理曲度,植骨融合术治疗颈椎后纵韧带骨化症既能后方直接减压,又能前方间接成压,椎管减压充分.一次手术达到前、后方2次手术的目的,使病人减少出血,减轻痛苦,大大节约住院费用,还可提供坚强的内固定,治疗效果满意.

Cervical ossification of posterior longitudinal ligament treated by posterior decompression and internal fixation of cervical lateral mass screw

Objective] To examine the clinical efficacy of posterior decompression and Vertex System internal fixation for cervical ossification of posterior longitudinal ligament(OPLL).Methods] 26 patients with OPLL were treated by cervical posterior decompression and Vertex System internal fixation.Among these patients,the upper cervical OPLL occurred in 5 cases,the lower cervical OPLL in 21 cases;one cervical section involved in 2 cases,2 in 4 cases,3 in 11 cases,4 in 5 cases,5 in 4 cases.Results] All the cases were followed up for a period of 3 months to 3 years and 8 months(average,18 months).The mean recovery rate based on the scoring system of the Japanese Orthopaedic Association(JOA)was 31%(from 3.4 to 7.6).No severe complications such as injuries of vertebral artery,nerve root and spinal cord or aggravation of spinal cord injury occurred.Conclusion] The satisfactory decompression of spinal cord can be achieved by total laminectomy for OPLL and the Vertex System internal fixation can perfectly reconstruct and maintain the cervical stability.