颈椎间盘并椎体后纵韧带部分切除治疗颈脊髓压迫症

目的探讨应用颈椎间盘、椎体及后纵韧带部分切除,植骨及带锁钢板内固定在治疗伴有后纵韧带压迫颈髓神经疾病中的应用. 方法单个椎间隙者13例手术采用前路间盘及相应部位后纵韧带部分切除,其余手术采用前路椎体大部分切除及相应部位后纵韧带部分切除,18例采用自体髂骨植骨融合,38例采用钛网笼内填充减压椎体之松质骨植骨,最后均予带锁钢板内固定. 结果术后复查MRI:见颈脊髓神经压迫去除满意.56例平均随访18个月,植骨全部于术后3～4个月骨性愈合.术后已恢复椎间隙高度没有发现再丢失现象,颈椎生理弧度恢复良好. 结论颈椎间盘及后纵韧带大部分切除术,颈椎及后纵韧带大部分切除术适用于部分伴有后纵韧带颈脊髓神经和神经根压迫症患者,有利于彻底解除神经压迫.

Application of cervical disc,vertebra and posterior longitudinal ligament partial resection to treat cervical spine cord compression

Objective To investigate the therapeutic effects of cervical disc , vertebra body and posterior longitudinal ligament partial resection with bone grafting and locked pate internal fixation to treat diseases because of posterior longitudinal ligament compression cervical spine cord. Methods Fiftysix cases , male thirty- six , female twenty. The rrimimum of years old is 35, maximal 74. average 56.6 years old . cervical spondylopathy 38 cases , cervical injury 18 cases. Pathological changes in one intervertebral space is 14 cases; in one vertebra and two intervertebral space is 37 eases ; in two vertebra and three intervertebral space is 5 cases. 13 cases which pathological changes in one intervertebral space have been treated cervical disc and posterior longitudinal ligament partial resection through anterior operative approach, others treated vertebra and posterior longitudinal ligament partial resection to treat cervical spine cord compression. 18cases is fused of ilium grafting, 38cases titanium mesh cage and anterior cervical locked plate fixed. Retsutlts MRI after operation revealed cervical spine compression is disappeared. The average range of follow - up is 18 months in 56 cases. Grafted bone is fusion in three or four months after operation. Highness of intervertebral space after operation is not decrease. The curve of cervical vertebrae come back . No plate and screws break off or slipping, After operation , Frankel grade improved one or two grade, among them, two cases upgrade from B grade to E grade. Conclusion Cervical disc and posterior longitudinal ligament partial resection , cervical vertebrae and posterior longitudinal ligament partial resection suit to treat cervical spine cord and nerve root compression. It is propitious to Spine cord downright decompression .