中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (4): 465-468.doi: 10.13418/j.issn.1001-165x.2021.04.019

• 临床研究 • 上一篇    下一篇

重建C2肌肉韧带复合体单开门椎管扩大成形术治疗累及C2 OPLL的临床观察

葛黁黁1,    樊成虎2,    齐兵献2,    唐仲海1,    路凯1   

  1. 1.甘肃中医药大学中医临床学院,  兰州    730000;    2.甘肃省中医院脊柱骨科,  兰州   730050
  • 收稿日期:2019-01-30 出版日期:2021-07-25 发布日期:2021-07-26
  • 通讯作者: 樊成虎,主任医师,硕士生导师,E-mail:fch0203@163.com
  • 作者简介:葛黁黁(1992-),硕士研究生,医师,研究方向:中西医防治脊柱疾病的研究,E-mail:2038643524 @qq.com
  • 基金资助:
    甘肃省中医药管理局科研课题(GZK-2017-29)

Clinical observation of reconstruction of C2 muscle ligamentous complex with open-door laminoplasty for the treatment of OPLL involving C2

Ge Nunnun1, Fan Chenghu2, Qi Bingxian2, Tang Zhonghai1,Lu Kai1   

  1. 1.Clinical College of Traditional Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China; 2.Department of Spinal Orthopedics, Gansu Provincial Hospital of TCM, Lanzhou 730050, China
  • Received:2019-01-30 Online:2021-07-25 Published:2021-07-26

摘要: 目的 观察重建C2肌肉韧带复合体单开门椎管扩大成形术治疗累及C2后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)的临床疗效。  方法    2016年3月至2018年6月,对本院19例采用重建C2肌肉韧带复合体单开门椎管扩大成形术治疗累及C2的OPLL患者进行回顾性分析。采用日本骨科协会(JOA)评分和视觉模拟量表(VAS)评分以评估其临床疗效。  结果 19例均获随访,随访时间为3~31个月。大部分患者四肢麻木无力、行走不稳症状获得良好改善。术后2例出现轴性症状,1例并发C5神经根麻痹症,经对症治疗后症状缓解。术前JOA评分为(8.26±1.63)分,术后末次随访时为(14.19±3.27)分,两者差异有统计学意义(P<0.05);术前VAS评分为(6.85±0.91)分,术后末次随访时为(1.06±0.89)分,差异有统计学意义(P<0.05)。疗效采用JOA评分标准判定:优11例,良5例,可3例。术后末次随访神经功能改善率为(78.96±12.83)%。  结论 重建C2肌肉韧带复合体单开门椎管扩大成形术治疗累及C2的OPLL手术操作难度低,并发症少,短期疗效显著。

关键词:  , 颈椎后纵韧带骨化症; 单开门椎管扩大成形术; C2肌肉韧带复合体

Abstract: Objective To observe the clinical effect of reconstruction of C2 muscle ligamentous complex with open-door laminoplasty for the treatment of OPLL  (ossification of posterior longitudinal ligament) involving C2. Methods From March 2016 to June 2018,a retrospective study was performed on 19 patients in our hospital who were treated with reconstruction of C2 muscle ligamentous complex with open-door laminoplasty for the treatment of OPLL involving C2. The JOA Score and VAS Score were used to assess clinical efficacy. Results All 19 cases were followed up for 3~31 months. Most of the patients with numbness, weakness of the limbs, walking instability symptoms had been well improved. Two patients had axial symptoms after operation, and one patient occurred C5 nerve root palsy. But the symptoms were relieved after symptomatic treatment. The preoperative JOA score was (8.26±1.63) points, (14.19±3.27) points at the postoperative follow-up. There was statistical difference in JOA score between preoperative and the final follow-up (P<0.05). The preoperative VAS score was (6.85±0.91) points, and (1.06±0.89) points at the postoperative follow-up.  There was statistical difference in VAS score between preoperative and the final follow-up (P<0.05). The efficacy was judged by JOA scoring criteria: excellent in 11 cases, good in 5 cases, and general in 3 cases. The postoperative neurological improvement rate was (78.96±12.83) % at the last follow-up. Conclusions Reconstruction of C2 muscle ligamentous complex with open-door laminoplasty for the treatment of OPLL involving C2 is less difficult to operate, with few complications, and significant short-term efficacy.

Key words: Ossification of posterior longitudinal ligament,  Open-door laminoplasty,  C2 muscle ligamentous complex

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