颈椎侧块钢板治疗颈椎后纵韧带骨化的探讨

目的探讨在颈椎后纵韧带骨化(OPLL)患者实施后路全椎板切除减压后,应用颈椎侧块钢板内固定的方式及疗效。方法1999年6月～2002年1月,12例OPLL患者采用后正中切口,显露至两侧关节突外缘,根据脊髓受压节段行全椎板切除后,采用Magerl方法行颈椎侧块钢板内固定加植骨术。结果随访8个月～2年4个月,平均18个月。根据JOA评分标准,平均改善率66%。未发生椎动脉或神经根损伤、脊髓损伤等严重并发症。结论OPLL患者行后路全椎板切除减压和颈椎侧块钢板内固定,既能有效改善颈椎管狭窄,又能避免全椎板切除对颈椎稳定性影响,疗效满意。

Study on Cervical Lateral Mass Plate for Internal Fixation in Ossification of Posterior Longitudinal Ligament

Objective To study the technique and therapeutic effect of total laminectomy and cervical lateral mass plate in patients with ossification of posterior longitudinal ligament(OPLL) in cervical vertebra. Methods During June 1999 to January 2002,12 OPLL patients received total laminectomy according to the compression segment of spinal cord. A cervical lateral mass plate was applied in each lateral mass and a suitable biocortical screw was inserted by Magerl technique. Results All of 12 cases were followed up from 8 months to 2 years and 4 months. The mean improved rate evaluated by the score of Japanese Orthopaedic Association (JOA)was 66 %.Severe complications such as injuries of vertebral artery, nerve root and spinal cord injury were not found. Conclusion The decompression with posterior total laminectomy and fixation by cerical lateral mass plate in OPLL can either relieve the cerical spinal canal stenosis effectively or avoid of the adverse effect of total laminectomy on cervical vertebra stability.