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| Comparison of Interim Efficacy of Different Surgical Procedures in the Treatment of Ossification of Posterior Longitudinal Ligament of Cervical Spine |
| WANG Shuai, LI Xian-zhou, GUO Hong-min,et al |
| Spinal Surgery,The First People's Hospital of Jining,Jining,Shandong, 272000 |
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Abstract 【Objective】To explore the interim efficacy of different surgical procedures in the treatment of ossification of posterior longitudinal ligament of cervical spine. 【Methods】Ninety-three cases of ossification of posterior longitudinal ligament of cervical spine treated in our hospital from January 2013 to January 2016 were selected. Twenty-seven patients underwent anterior cervical vertebral subtotal resection combined with bone grafting internal fixation as group A. 34 patients underwent posterior single open-door vertebral canal enlargement laminoplasty as group B, and 32 patients underwent total internal fixation with vertebral decompression and lateral mass screw fixation as group C. The Japanese Orthopedic Association (JOA) 17-point method was used to evaluate patients' neurological function and JOA scores before and 1 month after operation. (ROM) percentages and visual analogue scale (VAS) were compared between the three groups after one month. 【Results】The neurologic improvement was found : Excellent in 4 patients (14.8%), Good in 7 patients (25.9%), Fair in 12 patients (44.4%) and Poor in 4 patients (14.8%); 6 patients(17.6%) were found Excellent in the group B, 12 cases (35.2%) Good, 11 cases (32.4%) Fair and 5 cases (14.7%) Poor. The Group C found Excellent in 7 cases (21.9%), Good in 10 cases (31.3%), Fair in 11 cases(34.4% and Poor in 4 cases (12.5%). Neurological improvement rate of three groups of patients was equivalent ; the level of the group A was lower , the difference was statistically significant (P<0.05). Comparison of the incidence of axial symptoms, ROM percentage and VAS score of the three groups of patients found that the group C had lower incidence of axial symptoms, higher ROM percentile and lower VAS score, the difference was statistically significant (P<0.05).【Conclusion】Posterior cervical spine surgery is recommended for patients with ossification of the posterior longitudinal ligament of the cervical spine. The internal fixation of vertebral lamina decompression and lateral mass screw fixation can improve the rate of neurological improvement and decrease the degree of pain.
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Received: 18 January 2017
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[1] 张一龙,周非非,孙宇,等.颈椎后纵韧带骨化症自然病程的研究进展[J].中华医学杂志,2014,94(35):2793-2795.
[2] 陈文杰,王洪立,姜建元,等.胸椎后纵韧带骨化症的研究进展[J].中国骨与关节外科,2014,7(3):254-257.
[3] 张浩,周文超,刘洋,等.颈椎后纵韧带骨化症的影像学评估及外科治疗进展[J].医学研究杂志,2016,45(10):149-151.
[4] 杨中锋,陈洪亮,郑强,等.颈椎后纵韧带骨化症的手术治疗并发症探讨[J].临床和实验医学杂志,2014,13(22):1875-1877.
[5] 申沧海,冯永健,王力国,等.轻度颈椎后纵韧带骨化症保守治疗:预后因素及手术修复时机选择[J].中国组织工程研究,2015,19(4):531-536.
[6] 李勇.不同手术入路治疗颈椎后纵韧带骨化症的效果比较[J].中国当代医药,2014,21(33):33-35.
[7] 陈刚,戴腾,施克勤,等.后路单开门椎管成形术与全椎板切除减压术治疗颈椎后纵韧带骨化症的对比研究[J].中国矫形外科杂志,2016,24(7):598-602.
[8] 汪文龙,海涌,关立,等.前路或后路手术治疗颈椎后纵韧带骨化症的中期疗效观察[J].中国脊柱脊髓杂志,2016,26(7):577-584.
[9] 陈欣,庄颖峰,孙宇,等.单开门颈椎管扩大椎板成形术治疗颈椎后纵韧带骨化症的中远期疗效观察[J].中国脊柱脊髓杂志,2015,25(12):1057-1062.
[10] 刘春雨,金丽,彭宝淦,等.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[J].中国组织工程研究,2014,18(4):535-540.
[11] 石云志,刘泉.长节段颈椎后纵韧带骨化症修复:后路椎板切除植骨内固定与前路椎体次全切除减压的比较[J].中国组织工程研究,2014,18(53):8601-8606.
[12] 雷涛.前路手术治疗颈椎后纵韧带骨化症的力学分析和临床疗效研究[D].河北医科大学,2016.
[13] 张浩,周文超,陈元元,等.颈椎后纵韧带骨化症单开门椎管扩大成形术后颈椎矢状位参数变化与疗效的关系[J].中国脊柱脊髓杂志,2016,26(3):206-210.
[14] 施建东,卢一生,刘振刚,等.多节段脊髓型颈椎病与颈椎后纵韧带骨化症单开门椎管成形术疗效分析[J].颈腰痛杂志,2015,36(3):212-214.
(本文编辑:邓丽萍) [收稿日期] 2017-01-18
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2017, Vol. 34 
