中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2009年
2期
128-131
,共4页
杨大龙%申勇%董玉昌%丁文元%盂宪国%姚晓光%孟宪中%张为%曹俊明%李宝俊
楊大龍%申勇%董玉昌%丁文元%盂憲國%姚曉光%孟憲中%張為%曹俊明%李寶俊
양대룡%신용%동옥창%정문원%우헌국%요효광%맹헌중%장위%조준명%리보준
颈椎%骨硬化症%脊髓损伤%手术,外科
頸椎%骨硬化癥%脊髓損傷%手術,外科
경추%골경화증%척수손상%수술,외과
Cervical spine%Osteoaclerosis%Spinal cord injury%Surgery,operative
目的 探讨颈后纵韧带骨化后脊髓损伤的外科治疗手术入路选择. 方法 回顾性分析25例颈后纵韧带骨化后脊髓损伤患者手术治疗的临床资料.按照Frankel神经功能分类法分级:A级2例,B级3例,C级14例,D级6例.前路手术12例,后路手术8例,后前路联合手术5例. 结果 术中无大血管、气管、食管、脊髓损伤等严重并发症.所有患者均获随访,时间15~86个月,平均38.3个月,前路手术患者均获骨性融合,内固定无松动、断裂及脱出.后路手术患者术后X线及CT摄片显示无再次关门现象.21例患者脊髓功能获得不同程度改善,4例尤改善者上肢疼痛、麻木有不同程度的缓解. 结论 采用前路、后路或后前路联合入路治疗颈后纵韧带骨化后脊髓损伤均取得良好临床疗效,根据影像学表现结合患者全身情况合理选择手术入路是手术成功的关键.
目的 探討頸後縱韌帶骨化後脊髓損傷的外科治療手術入路選擇. 方法 迴顧性分析25例頸後縱韌帶骨化後脊髓損傷患者手術治療的臨床資料.按照Frankel神經功能分類法分級:A級2例,B級3例,C級14例,D級6例.前路手術12例,後路手術8例,後前路聯閤手術5例. 結果 術中無大血管、氣管、食管、脊髓損傷等嚴重併髮癥.所有患者均穫隨訪,時間15~86箇月,平均38.3箇月,前路手術患者均穫骨性融閤,內固定無鬆動、斷裂及脫齣.後路手術患者術後X線及CT攝片顯示無再次關門現象.21例患者脊髓功能穫得不同程度改善,4例尤改善者上肢疼痛、痳木有不同程度的緩解. 結論 採用前路、後路或後前路聯閤入路治療頸後縱韌帶骨化後脊髓損傷均取得良好臨床療效,根據影像學錶現結閤患者全身情況閤理選擇手術入路是手術成功的關鍵.
목적 탐토경후종인대골화후척수손상적외과치료수술입로선택. 방법 회고성분석25례경후종인대골화후척수손상환자수술치료적림상자료.안조Frankel신경공능분류법분급:A급2례,B급3례,C급14례,D급6례.전로수술12례,후로수술8례,후전로연합수술5례. 결과 술중무대혈관、기관、식관、척수손상등엄중병발증.소유환자균획수방,시간15~86개월,평균38.3개월,전로수술환자균획골성융합,내고정무송동、단렬급탈출.후로수술환자술후X선급CT섭편현시무재차관문현상.21례환자척수공능획득불동정도개선,4례우개선자상지동통、마목유불동정도적완해. 결론 채용전로、후로혹후전로연합입로치료경후종인대골화후척수손상균취득량호림상료효,근거영상학표현결합환자전신정황합리선택수술입로시수술성공적관건.
Objective To investigate the appropriate surgical approach in the management of cervical cord injury following ossification of the posterior longitudinal ligament. Methods The clinical data of 25 patients with cervical cord injury following ossification of the posterior longitudinal ligament who received surgical treatment were retrospectively analyzed. According to Frankel grades, two patients were at grade A, three at grade B, 14 at grade C and six at grade D. The surgical procedures consisted of anterior decompression (12 patients), posterior decompression (8 patients) and combined posteroanterior decompression (5 patients). Results No iatrogenic injury of great vessels, trachea, esophagus or spinal cord occurred. All the patients were followed up for 15-86 months (mean 38.3 months). All segments with anterior fixation attained solid fusion, without implants loosening or breakage. No reelosed open-door was found in patients who received posterior laminoplasty. The spinal function got improved in 21 patients, and a relief of pain or numb of the upper limb was attained in four patients whose spinal cord injury was not cured. Conclusions The surgical outcome of cervical cord injury following ossification of the posterior longitudinal ligament is satisfactory. It is important to select a suitable surgical approach according to the imaging manifestations associated with the general conditions of the patients.