【摘要】：目的:探討頸后路雙開門椎管減壓擴(kuò)大成形術(shù)中使用內(nèi)固定(LA椎板夾)對于多階段的頸椎后縱韌帶骨化癥(OPLL)的療效及預(yù)后效果分析。方法:回顧性研究2013-2015行頸后路雙開門椎管減壓擴(kuò)大成形術(shù)治療多節(jié)段頸椎后縱韌帶骨化癥患者26例,其中男22例,女4例,年齡42-77歲,平均56.4歲,平均隨訪時間13個月,患者術(shù)前全部常規(guī)行頸椎X線正側(cè)位及過伸過屈位片、CT平掃加矢狀位重建及MRI檢查。臨床療效使用日本骨科學(xué)會(JOA)來評分以及影像學(xué)檢查評估,并計算手術(shù)前后頸椎CT平掃狹窄層面的椎管有效矢狀徑,計算椎管矢狀徑改善率。在MRI圖像上評價術(shù)前脊髓受壓節(jié)段的壓迫程度評分以及脊髓線(SC線)分型,并分析術(shù)后脊髓減壓程度和SC線分型的關(guān)系。采用SPSS17.0統(tǒng)計分析軟件用于統(tǒng)計分析,P0.05差異具有顯著性。結(jié)果:26例患者均順利完成手術(shù),進(jìn)行隨訪研究后發(fā)現(xiàn),LA椎板夾用于頸椎后路雙開門椎管減壓擴(kuò)大成形術(shù)取得了令人滿意的療效。JOA評分改善率55%,I型SC線者術(shù)后減壓滿意,術(shù)前脊髓壓迫評分平均3.77±0.42分,術(shù)后平均1.13±0.34分;Ⅱ型者術(shù)后得到大部分減壓,術(shù)前平均3.86±0.35分,術(shù)后平均2.73±0.46分;III型者減壓不滿意,術(shù)前平均4.00±0.00分,術(shù)后平均3.64±0.50分,比較差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:LA椎板夾用于頸后路雙開門椎管減壓擴(kuò)大成形術(shù)治療OPLL療效滿意,能夠有效的改善脊髓壓迫程度,提高患者的生活質(zhì)量,改善預(yù)后。
[Abstract]:Aim: to evaluate the efficacy and prognosis of internal fixation (LA lamina clamp) in the treatment of multistage ossification of the posterior longitudinal ligament of cervical spine (OPLL). Methods: twenty-six patients (22 males and 4 females) with ossification of the posterior longitudinal ligament of the cervical spine were treated with posterior cervical decompression and open-door laminoplasty in 2013 / 2015. The mean age was 56.4 years (n = 42), with a mean age of 56.4 years (n = 42). The mean follow-up time was 13 months. All patients underwent X-ray and over-extension flexion X-ray, CT plain scan plus sagittal reconstruction and MRI examination before operation. The clinical efficacy was evaluated by the Japanese Orthopaedics Society (JOA), and the effective sagittal diameter of the spinal canal was calculated by CT before and after the operation, and the improvement rate of the sagittal diameter of the spinal canal was calculated. The score of compression degree and the classification of spinal cord line (SC line) were evaluated on MRI images, and the relationship between the degree of spinal cord decompression after operation and the classification of SC line was analyzed. SPSS17.0 statistical analysis software was used for statistical analysis, P0.05 significant difference. Results: all the 26 patients successfully completed the operation. The follow-up study showed that the LA laminae clip was used to expand the decompression of the posterior cervical vertebrae with double-door decompression. The improvement rate of JOA score was 55%, and the improvement rate of JOA score was 55%. The spinal cord compression score was 3.77 鹵0.42 before operation and 1.13 鹵0.34 after operation. Most of the patients with type 鈪，

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