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后路椎板切除术联合后路钢丝固定及融合术治疗颈椎后纵韧带骨化症、颈椎病、黄韧带骨化症、椎管狭窄症及颈椎不稳:5例患者的研究

Laminectomy with posterior wiring and fusion for cervical ossification of the posterior longitudinal ligament, spondylosis, ossification of the yellow ligament, stenosis, and instability: a study of 5 patients.

作者信息

Epstein N E

机构信息

Department of Surgery (Neurosurgery), North Shore University Hospital-NYU School of Medicine, New York, New York 11042, USA.

出版信息

J Spinal Disord. 1999 Dec;12(6):461-6.

Abstract

Cervical laminectomy with posterior wiring and fusion is valuable for the management of cervical ossification of the posterior longitudinal ligament (OPLL), spondylosis, ossification of the yellow ligament (OYL), stenosis, and instability. Within 1.5 years, five patients averaging 73 years of age developed severe myelopathy. Dynamic radiographs confirmed an intact cervical lordosis with active subluxation and instability at one or two levels, whereas magnetic resonance and computed tomography scans showed OPLL, spondylosis, OYL, and stenosis. After multilevel laminectomy with posterior wiring and fusion and immobilization in cervicothoracic orthoses, patients fused in an average of 3.6 months. All patients improved, showing mild to moderate residual postoperative myelopathy an average of 13 months later (range, 6-19 months). With an intact cervical lordosis, laminectomy with posterior wiring and fusion was used successfully to manage five patients with OPLL, spondylosis, OYL, stenosis, and instability.

摘要

后路椎板切除术联合后路钢丝固定及融合术对于治疗颈椎后纵韧带骨化症(OPLL)、颈椎病、黄韧带骨化症(OYL)、椎管狭窄及颈椎不稳具有重要价值。在1.5年内,5例平均年龄73岁的患者出现了严重的脊髓病。动态X线片证实颈椎生理前凸存在,且在一个或两个节段有活动性半脱位及不稳,而磁共振成像和计算机断层扫描显示存在OPLL、颈椎病、OYL及椎管狭窄。在进行多节段椎板切除联合后路钢丝固定及融合术并使用颈胸矫形器固定后,患者平均在3.6个月时实现融合。所有患者均有改善,平均在术后13个月(范围为6 - 19个月)时显示出轻度至中度的术后残留脊髓病。在颈椎生理前凸存在的情况下,后路椎板切除术联合后路钢丝固定及融合术成功用于治疗5例患有OPLL、颈椎病、OYL、椎管狭窄及颈椎不稳的患者。

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