Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
World Neurosurg. 2011 Mar-Apr;75(3-4):546-50. doi: 10.1016/j.wneu.2010.10.041.
To present a small case series reporting the outcomes of surgical treatment for myelopathy caused by cervical ossification of the ligamentum flavum (OLF).
The authors assessed 15 cases of myelopathy caused by cervical OLF. Patients were eight women and seven men 37-75 years old (mean age 59.7 years). All patients underwent bilateral laminectomy, and the lesions were removed. The decompression range was confined within the medial sides of the bilateral facets and within the involved segments. Intraoperative specimens were examined histologically to confirm the diagnosis. During the operation, the extent of adherence of the lesions to the dura was recorded. The patients were followed for 3-70 months. Neurofunctional improvements were evaluated with the Japanese Orthopaedic Association (JOA) score.
Definite adherences were present in 67.7% of all cases. JOA score showed a 71.5% improvement after operation from a preoperative score of 5-8 (mean 6.4) to a postoperative score of 10-14 (mean 13.5). The operative outcomes were satisfactory without extensive decompression of adjacent segments.
A high rate of adherence to the dura was observed in patients with myelopathy caused by cervical OLF. Bilateral laminectomy and removal of the lesions, without extensive decompression of adjacent segments, provides an optimistic prognosis.
报告一组颈椎黄韧带骨化（OLF）所致脊髓病手术治疗结果的小病例系列。
作者评估了 15 例由颈椎 OLF 引起的脊髓病患者。患者为 8 名女性和 7 名男性，年龄 37-75 岁（平均年龄 59.7 岁）。所有患者均行双侧椎板切除术，切除病变。减压范围局限于双侧关节突内侧和受累节段内。术中标本行组织学检查以明确诊断。术中记录病变与硬脑膜的粘连程度。患者随访 3-70 个月。采用日本矫形协会（JOA）评分评估神经功能改善情况。
所有病例中，明确粘连的比例为 67.7%。JOA 评分显示，术后从术前 5-8 分（平均 6.4 分）提高到术后 10-14 分（平均 13.5 分），改善率为 71.5%。手术结果令人满意，无需广泛减压相邻节段。
颈椎 OLF 所致脊髓病患者硬脑膜粘连率较高。双侧椎板切除和病变切除，无需广泛减压相邻节段，可获得良好的预后。
