颈椎后方韧带复合体也许是多节段颈椎病后路手术的新思路

颈椎病是影响国人乃至全人类最常见的脊柱退行性疾患之一，颈椎病会给病人带来极大的不适和生活困扰。后路减压手术是治疗颈椎病，尤其是多节段颈椎病变最常用的手术方式。然而，后路手术需将颈椎棘突和附着在其上的棘上、棘间韧带部分或完全切除，从而破坏了颈椎后方韧带复合体的功能，术后病人易出现颈椎反曲、鹅颈畸形、颈椎失稳，甚至出现迟发性脊髓神经受压。所以，近年来越来越多的研究开始集中于避免破坏颈椎后方韧带复合体，国内外学者从集中术式改良和手术入路改良两方面进行了一些研究，均直接或间接的证明了保留颈椎后方韧带复合体的手术方式具有更好的治疗效果。故本文就近年来保留颈椎后方韧带复合体的术式研究作一综述，希望能为未来多节段退变性颈椎病后路的治疗提供一个新的思路。

Cervical Posterior Ligamentous Complex Maybe the New Ideas for Posterior Surgery of Multi-segment Cervical Spondylotic Myelopathy

Cervical spondylosis is one of the most common degenerative diseases of the spine that affects the Chinese people and even the whole mankind. Cervical spondylosis can bring great discomfort and life troubles to patients. Posterior cervical decompression surgery is the most commonly used surgical method to treat cervical spondylosis, especially multi-segment degenerative cervical spondylotic myelopathy. At present, cervical laminectomy and laminoplasty (single open-door laminoplasty and double open-door laminoplasty) are still the main implementation methods of posterior cervical decompression surgery. However, these surgical procedures require partial or complete removal of the cervical spinous process and the supra-spinous and interspinous ligaments attached to it, thereby destroying the function of the cervical posterior ligamentous complex. Postoperative patients are prone to cervical retroflexion, swan-neck deformity, cervical spine instability, and even delayed spinal nerve compression. The cervical posterior ligamentous complex has an irreplaceable role in maintaining the stability and physiological curvature of the vertebral body. This article reviews the posterior surgical treatment of multi-segment degenerative cervical spondylotic myelopathy and the research on the cervical posterior ligamentous complex, hoping to provide a new idea for the future treatment of mmulti-segment degenerative cervical spondylotic myelopathy.