全椎板切除术治疗颈椎后纵韧带合并黄韧带骨化致颈椎脊髓病的疗效分析(1)
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[摘要] 目的 探讨颈椎后纵韧带骨化合并黄韧带骨化的手术治疗方法及其术后疗效的影响因素。方法 回顾性分析2007年5月~2011年3月在我院进行手术治疗的36例颈椎后纵韧带骨化合并黄韧带骨化患者，全部患者均采用全椎板切除减压，随访术后脊髓功能恢复情况，分析术前病程、术前JOA评分(日本矫形外科学会，17分)、硬化节段、脊髓信号改变与术后疗效的关系。结果 36例患者均获得随访，随访时间在10个月～4年，平均16个月。根据JOA评分标准进行术前和术后的疗效评价。术后JOA评分平均为14.36(11～17)，较术前9.64(7～13)有显著改善(t=10.48，P<0.01)，术后疗效评价为优20例、良11例、可5例，优良率达86.1%。结论 全椎板切除减压是治疗颈椎后纵韧带骨化合并黄韧带骨化的可靠、有效的手术方式。术前病程短、JOA评分高、单节段骨化及矢状位T2加权像髓内信号无改变的病例术后疗效好。
[关键词] 颈椎；黄韧带骨化；后纵韧带骨化；手术治疗；术后疗效
[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701(2011)34-54-03
Laminectomy in the Treatment of Cervical Ossification of Posterior Longitudinal Ligament Combined Ossification of Ligamentum Flavum Caused Cervical Spinal Cord Disease, the Efficacy Analysis
CHEN Deqiang XUE Yuan
Tianjin Medical University General Hospital Orthopedics, Tianjin 300134, China
[Abstract] Objective To investigate ossification of cervical posterior longitudinal ligament and ligamentum flavum surgical treatment and postoperative factors affecting the efficacy. Methods A retrospective analysis from May 2007 to March 2011 in our hospital for surgical treatment of 36 cases of cervical OPLL combined OLF patients, all patients were treated with decompression laminectomy, spinal cord function after follow-up recovery, preoperative duration of disease, preoperative JOA score (Japanese Orthopaedic Association, 17 points), segmental sclerosis, spinal cord signal changes and the curative effect relationship. Results All 36 patients were followed up for 10 months to 4 years, an average of 16 months. According to the JOA score of preoperative and postoperative evaluate the efficacy. Postoperative JOA score was 14.36 (11-17), compared with the preoperative 9.64 (7-13) have improved significantly (t=10.48, P<0.01), Excellent curative effect evaluation of 20 cases, good in 11 cases, 5 cases, good rate of 6.1%. Conclusion Decompression laminectomy is a reliable and effective surgical approach to treating cervical ossification of posterior longitudinal ligament and ligamentum flavum ......
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