颈椎后纵韧带骨化症的手术治疗及疗效分析

目的] 探讨颈椎后纵韧带骨化症（OPLL）手术治疗方法、疗效及其并发症。方法] 对本组自2000年以来手术治疗的48例OPLL患者的临床资料进行回顾性总结分析。其中前路手术18例，后路手术30例，按照JOA评分标准判定其术后改善率，对患者术前术后X线、CT及MRI影像学资料进行比较分析，并统计手术并发症。结果] 48例患者中合并原发性椎管狭窄23例，平均椎管狭窄率41．4％，术前MRI示脊髓信号改变者19例；前路手术平均改善率68．3％，后路手术平均改善率51．3％；术后并发脑脊液漏2例，节段性神经根麻痹5例，血肿2例。结论] 应根据后纵韧带骨化部位、范围及椎管狭窄率选择合适手术方法，方能减少并发症，提高手术疗效。

Surgical treatment and results of ossification of posterior longitudinal ligament of cervical spine

Objective]To discuss surgical approaches,results and complications of ossification of posterior longitudinal ligament(OPLL)of cervical spine.Method]The clinic data of 48 patients from 2000 with cervical OPLL were reviewed and analyzed.Eighteen of them were decompressed from an anterior approach and 30 from a posterior approach.The improvement rate according to JOA scoring system were evaluated,some relevant imaging examination data including X-rays,CT and MRI were also measured,which were taken preand post-operatively.Surgical complications were also recorded.Result]Of 48 patients,23 had cervical stenosis,the mean occupancy rate was 41.4%,and 19 had the abnormal signal in spinal cord.The mean postoperative improvement rate was 68.3% in patients treated by anterior decompression and 51.3% in those treated by posterior decompression.There were 2 patients with dural tear,5 with segmental nerve root palsy and 2 with hematoma after operation.Conclusion]Suitable operation methods should be chosen according to the location,extent and occupancy ratio of OPLL,which is important for avoiding complications and improving surgical results.