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[后纵韧带骨化症患者颈脊髓损伤的临床特征及结果]

[Clinical characteristics and results of cervical spinal cord injury in the patients with ossification of the posterior longitudinal ligament].

作者信息

Chen De-yu, He Zhi-min, Chen Hua-jiang, Wang Xin-wei, Chen Yu, Guo Yong-fei, Yang Hai-Song, Tian Hai-Jun

机构信息

Department of Orthopaedic, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Mar 15;45(6):370-2.

Abstract

OBJECTIVE

To investigate the clinical characteristics and results of cervical spinal cord injury (SCI) in the patients with ossification of the posterior longitudinal ligament (OPLL).

METHODS

Nineteen patients with cervical SCI associated with OPLL were retrospectively analyzed. Data collection included: pre- and postoperative neurological function, OPLL-type, MRI signal changes and surgical approaches.

RESULTS

Spinal cord associated with OPLL was injured severely by mild trauma. Methylprednisolone sodium succinate was used within 8 h after trauma in 12 cases. Two of them died of complications. The neurological functions were markedly improved in the other 10 cases. Seventeen cases had surgical treatment. The neurological functions (Frankel grade) were improved significantly in the operated patients except for one, who died 27 d after operation.

CONCLUSIONS

The patients with OPLL are prone to have severe SCI, which directly associates with the preexisting OPLL-type and hyper-intensity signal change in the spinal cord on MRI. Both of using methylprednisolone sodium succinate administration within 8 h after trauma and surgical decompression may improve the neurological outcomes.

摘要

目的

探讨后纵韧带骨化症(OPLL)患者颈椎脊髓损伤(SCI)的临床特征及治疗结果。

方法

回顾性分析19例伴有OPLL的颈椎SCI患者。收集的数据包括:术前和术后神经功能、OPLL类型、MRI信号变化及手术方式。

结果

伴有OPLL的脊髓因轻度外伤而严重受损。12例患者在伤后8小时内使用了甲泼尼龙琥珀酸钠。其中2例死于并发症。其他10例患者神经功能明显改善。17例接受了手术治疗。除1例术后27天死亡外,手术患者的神经功能(Frankel分级)明显改善。

结论

OPLL患者易发生严重SCI,这与既往存在的OPLL类型及MRI上脊髓高强度信号改变直接相关。伤后8小时内使用甲泼尼龙琥珀酸钠及手术减压均可改善神经功能结局。

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