Zhang Jun-wei, Hirabayashi Shigeru, Hong Yi
Department of Spine Surgery, China Rehabilitation Research Center and Department Orthopedic Surgery, the Capital University of Medical Science, Beijing 100068, China.
Zhonghua Wai Ke Za Zhi. 2008 Sep 1;46(17):1329-32.
To evaluate the effectiveness of Tension-band Laminoplasty (TBL) as a management for cervical ossification of posterior longitudinal ligament (OPLL).
Forty-six patients with cervical OPLL and undergone TBL in our department were chosen for the present study, including 33 male and 13 female. The mean age was 59 years (36 - 77 years). These OPLLs were confirmed as following types: 4 cases of single spinal level, 20 cases of continuous and 22 cases of mixed type. C(3) or/and C(2) levels were involved in 16 cases. All the patients underwent C(2 - 7) TBL, to which C(1) laminectomy was added for the cases with C(3) and/or C(2) involved. The neurological effect was evaluated by using Japanese Orthopedic Association (JOA) scoring criteria for cervical myelopathy. The anatomical effect was analyzed by comparing the pre- and post-operatively roentgenograms and MRIs. Wilcoxon's rank test was used for the statistics study.
For 42 (91.3%) patients, the JOA scores were improved for approximately 2 points after the operation, posterior shift of the spinal cord was obtained, while the diameters of dural sleeves and spinal cords were enlarged, yet the spinal alignments were not significantly interrupted.
TBL was proved an effective treatment for cervical OPLL and it could be expanded to include C(1) laminectomy if the spinal levels upper than C(4) were involved.
评估张力带椎板成形术（TBL）治疗颈椎后纵韧带骨化症（OPLL）的有效性。
选取在我科接受TBL治疗的46例颈椎OPLL患者，其中男性33例，女性13例。平均年龄59岁（36 - 77岁）。这些OPLL确诊为以下类型：单节段4例，连续型20例，混合型22例。16例累及C3或/和C2节段。所有患者均接受C2 - 7 TBL，累及C3和/或C2节段的患者加做C1椎板切除术。采用日本骨科协会（JOA）脊髓病评分标准评估神经功能效果。通过比较术前和术后的X线片及磁共振成像（MRI）分析解剖学效果。采用Wilcoxon秩和检验进行统计学研究。
42例（91.3%）患者术后JOA评分提高约2分，脊髓后移，硬脊膜囊和脊髓直径增大，但脊柱排列未明显中断。
TBL被证明是治疗颈椎OPLL的有效方法，如果累及C4以上节段可加做C1椎板切除术。
