颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及治疗.docVIP

颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及治疗 【摘要】 探讨颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及其治疗。［方法］对76例颈椎后纵韧带骨化症患者的临床资料进行回顾性分析。根据原始X线片测量颈椎椎体、椎管矢状径，计算Pavlov比值，根据计算结果将患者分为伴发育性椎管狭窄颈椎后纵韧带骨化症组（DSS组）和不伴发育性椎管狭窄颈椎后纵韧带骨化症组（NDSS组）。根据CT分别测量两组骨化灶最大厚度，计算椎管矢状径残存率。其中前路手术4例，后路手术72例，按JOA标准评分判断术后改善率。［结果］DSS组53例，NDSS组23例；NDSS组骨化灶最大厚度比DSS组大，有统计学意义；发病时两组椎管矢状径残存率有差异，但是无统计学意义；两组术前、术后3个月JOA评分有差别，但是无统计学意义。［结论］发育性椎管狭窄是影响颈椎后纵韧带骨化症病程的重要病理基础，创伤是诱发其发病的主要因素，后路减压术是一种较合理的治疗方式。 【关键词】 颈椎 后纵韧带骨化 发育性椎管狭窄 创伤 手术治疗 Abstract：［Objective］To discuss clinic feature and treatment of ossification of cervical posterior longitudinal ligament associated with developmental spinal stenosis.［Method］The clinic data of 76 patients with ossification of cervical posterior longitudinal ligament were reviewed and analyzed.Measuring the middlesagittal diameter ratio of vertebral canal and vertebral body by the original lateral cervical vertebra Xray and calculating Pavlov ratio.All the enrolled patients were divided into two groups:DSS group consisted of 53 patients associated with developmental spinal stenosis,NDSS group consisted of 23 patients without developmental spinal stenosis.Measuring the biggest thickness of ossification focus and the residual sagittal diameter of the spinal canal rate at the narrowest level attributable to OPLL.4 of them were decompressed from an anterior approach and 72 from a posterior approach.The improvement rate according to JOA scoring were evaluated.［Result］DSS group consisted of 53 patients,NDSS group consisted of 23 patients.The biggest thickness of ossification focus,NDSS group＞DSS group,with statistical significance.The residual sagittal diameter of the spinal canal rate at the narrowest level,NDSS group＞DSS group,although without statistical significance.JOA score of two groups before and after surgery without statistical significance.［Conclusion］Developmental spinal stenosis is pathology found,which influences course of ossification of cervical posterior longitudinal l