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100039AnteriorapproachorcombinedanteriorandposteriorapproachesforsevereossificationofcervicalposteriorlongitudinalligamentLiuChun-yu,JinLi,PengBao-ganDepartmentSpinalSurgery,ArmedPoliceGeneralHospital,Beijing100039,China全文:PDF(792KB)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，C3-7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；后路减压；Abstract：BACKGROUND:Itiscontroversialwhetheranteriorapproachalone,orcombinedanteriorandposteriorapproacheswereusedforhighlevelandmultiplesegmentsofsevereossificationofcervicalposteriorlongitudinalligament.OBJECTIVE:Toexplorethedifferenceofanteriorapproachversuscombinedanteriorandposteriorapproachesforthetreatmentofhighlevelandmultiplesegmentsofsevereossificationofcervicalposteriorlongitudinalligament.METHODS:Atotalof21casesofhighlevelandmultiplesegmentsofsevereossificationofcervicalposteriorlongitudinalligamentwereincludedinthisstudy.Therewere9males,aged56-72years,and12females,aged58-70years.Weusedanteriordecompressionandtitaniummeshbonegraftfusionin11caseswhichlesionlocatedbetweenC2-5vertebra,andossificationexcision,combinedanterior(titaniummeshplateandscrew)andposterior(lateralmassscrew)approachesin10caseswhichbetweenC3-7vertebra.JapaneseOrthopaedicAssociationscoresystemwasusedtoevaluatetheresults.Theexcellentandgoodrateandimprovementratewerecalculated.RESULTSANDCONCLUSION:Theexcellentandgoodratewas90%andimprovementratewas82%in10casesusingcombinedanteriorandposteriorapproaches.Theexcellentandgoodratewas73%andimprovementratewas73%in11casesusinganteriortreatmentalone.Significantdifferencesintheexcellentandgoodrateandimprovementrateweredetectedbetweenthetwogroups(P<0.05).Thesesuggestedthatcombinedanteriorandposteriorapproachesforhighlevelandmultiplesegmentsofsevereossificationofcervicalposteriorlongitudinalligamentisabetteroperativeprocedure.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：Keywords：cervicalvertebrae;ossification;posteriorlongitudinalligament;decompression;internalfixators;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。