1、颈椎前路或前后路联合植入物内固定治疗严重后纵韧带骨化症刘春雨，金 丽，彭宝淦武警总医院脊柱外科，北京市 100039Anterior approach or combined anterior and posterior approaches for severe ossification of cervical posterior longitudinal ligamentLiu Chun-yu, Jin Li, Peng Bao-ganDepartment Spinal Surgery, Armed Police General Hospital, Beijing 100039, Chin
2、a全文: PDF (792 KB) 输出: BibTeX | EndNote (RIS) 摘要 背景：高位、多节段严重颈椎后纵韧带骨化症是采用单纯前路，还是采用前后路联合入路治疗方式存在争议。目的：对比分析前路及前后路联合治疗高位、多节段严重颈椎后纵韧带骨化症的差异。方法：选择高位、多节段严重颈椎后纵韧带骨化症患者 21 例。男 9 例，年龄在 56-72 岁；女 12 例，年龄在 58-70 岁。病变位于 C2-5 间 11 例，C 3-7 之间 10 例。其中 11 例采用单纯颈椎前路减压、钛网植骨融合内固定治疗；10 例采用颈椎后纵韧带骨化切除、前路钛网钢板螺钉内固定、后路侧块螺钉内固定
3、联合治疗。治疗结果采用 JOA 评分标准，计算优良率及改善率。结果与结论：10 例采取前后路联合治疗方法患者优良率为 90%，改善率为 82%。11 例单纯采取颈椎前路治疗方法的患者中优良率为 73%，改善率为 73%。两组优良率比较及改善率比较，差异均有显著性意义(P 0.05)。从而说明高位、多节段严重颈椎后纵韧带骨化症采用颈椎后纵韧带骨化切除、前路钛网钢板螺钉内固定、后路侧块螺钉内固定是一种较好的治疗方式。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程关键词 ： 植入物； 脊柱植入物； 颈椎； 颈椎后纵韧带骨化； 颈椎前后路联合； 前路减压
4、； 后路减压； Abstract： BACKGROUND: It is controversial whether anterior approach alone, or combined anterior and posterior approaches were used for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament.OBJECTIVE: To explore the difference of anterior approach
5、 versus combined anterior and posterior approaches for the treatment of high level and multiple segments of severe ossification of cervical posterior longitudinal ligament.METHODS: A total of 21 cases of high level and multiple segments of severe ossification of cervical posterior longitudinal ligam
6、ent were included in this study. There were 9 males, aged 56-72 years, and 12 females, aged 58-70 years. We used anterior decompression and titanium mesh bone graft fusion in 11 cases which lesion located between C2-5 vertebra, and ossification excision, combined anterior (titanium mesh plate and sc
7、rew) and posterior (lateral mass screw) approaches in 10 cases which between C3-7 vertebra. Japanese Orthopaedic Association score system was used to evaluate the results. The excellent and good rate and improvement rate were calculated.RESULTS AND CONCLUSION: The excellent and good rate was 90% and
8、 improvement rate was 82% in 10 cases using combined anterior and posterior approaches. The excellent and good rate was 73% and improvement rate was 73% in 11 cases using anterior treatment alone. Significant differences in the excellent and good rate and improvement rate were detected between the t
9、wo groups (P 0.05). These suggested that combined anterior and posterior approaches for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament is a better operative procedure.中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：Key words： cervical vertebrae; ossification; posterior longitudinal ligament; decompression; internal fixators; 中图分类号: R318 通讯作者: 彭宝淦，主任医师，教授，武警总医院脊柱外科，北京市 100039 作者简介: 刘春雨，男， 1983 年生，北京市人，满族，医师，主要从事脊柱外科的研究。
