脊髓型颈椎病颈前路手术后纵韧带切除的临床效果

目的观察后纵韧带切除在颈前路手术治疗脊髓型颈椎病(CSM)的临床疗效。方法选择CSM行颈前路减压术患者32例,分为两组:A组12例,行颈椎后纵韧带切除术;B组20例,未行后纵韧带切除。用MRI技术测量脊髓矢状径,用JOA评分系统进行临床疗效评价。结果随访3-24个月。采用日本矫形外科协会标准进行评分,A组术后与术前评分差值大于B组(5.50±0.90)分vs.(2.40±0.89)分](P<0.01);MRI显示,A组术后与术前脊髓矢状径差值大于B组(3.363±0.258)mm vs.(2.637±0.412)mm](P<0.05)。结论颈椎前路切骨减压时行增生后纵韧带切除可使病变节段减压更加彻底,有利于CSM患者脊髓形态的恢复。

Clinical outcomes of posterior longitudinal ligament resection during cervical operation for treating cervical spondylotic myelopathy via anterior approach

Objective To observe the outcomes of posterior longitudinal ligament(PLL) resection during cervical operation for treating cervical spondylotic myelopathy(CSM) via anterior approach.Methods Thirty-two cases with CSM were divided into two groups of A(12 cases,operated with PLL resection) and B(20 cases,operated without PLL resection).MRI and JOA scoring were perfirmed after operation.Results The patients were followed-up for 3-24 months.The shape of the durasac recoverd very well in group A.The difference of JOA scores of spinal cord between before and after operation was greater in group A than that in group B (5.50±0.90) points vs.(2.40±0.89) points](P<0.01).The difference of saggittal diameter of spinal cord between before and after operation was greater in group A than that in group B (3.363±0.258) mm vs.(2.637±0.412) mm](P<0.05).Conclusion PLL resection during cervical operation for treating CSM has better effectiveness in the decompression and is helpful in recovering the posture of the spinal cord.