颈椎后纵韧带骨化症与退变性椎管狭窄症采用单开门椎板成形术临床及影像学比较简

目的比较退变性颈椎管狭窄症（CDS）和颈椎后纵韧带骨化症（OPLL）采用颈后路单开门椎板成形术治疗的临床疗效及影像学改变。方法回顾性分析采用颈后路单开门椎板成形结合ARCH微型钛板内固定术治疗的节段性OPLL（OPLL组）及多节段CDS（CDS组）共78例的临床资料，比较2组手术失血量、手术时间、手术并发症、神经功能改善情况及颈椎活动度的变化等。结果术中失血量、手术时间及Cobb角（C2-7）丢失值2组比较，差异有统计学意义（P〈0．001）：神经功能改善率及手术并发症2组比较，差异无统计学意义（P〉0．05）。结论OPLL及CDS患者采用该术式均可获得较好的临床疗效，但OPLL患者术中失血量、手术时间以及颈椎活动度丢失均大于CDS患者。

A clinical and radiographic comparison between cervical degenerative stenosis and ossification of posterior longitudinal ligament after single open-door instrumented laminoplasty

Objective To compare the clinical and radiographic differences between patients with multilevel cervical degenerative stenosis（CDS） and those with ossification of the posterior longitudinal ligament（OPLL） after posterior, single open- door instrumented laminoplasty. Methods A total of 78 patients with either multilevel CDS or segmental OPLL were treated with posterior, single open-door instrumented laminoplasty. Peri-operative and follow-up data, including radiographic results were collected. Results Compared to the CDS patients, the OPLL patients had more estimated blood loss and longer operative time（P 〈0.001）. The extent of the loss of sagittal cervical range of motion after laminoplasty was greater in the OPLL group（P 〈 0.001）. There were no significant differences in the pre- and post-operative JOA scores or recovery ratio and the rate of complications between the two groups（P 〉0.05）. Conclusion The instrumented laminoplasty using ARCH plate could lead to a significant neurological improvement and minor complications in each group, however, the EBL and loss of cervical ROM are more in patients with OPLL than those with multilevel CDS.