Department of Spinal Surgery, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
Orthop Surg. 2011 May;3(2):95-101. doi: 10.1111/j.1757-7861.2011.00131.x.
To identify an appropriate surgical approach for the management of cervical cord injury with ossification of the posterior longitudinal ligament.
A retrospective study of 25 cases of cervical cord injury with ossification of the posterior longitudinal ligament was performed. Two cases were classified as Frankel grade A, three as grade B, fourteen as grade C, and six as grade D. Treatment procedures consisted of anterior decompression with instrumentation (twelve patients), posterior decompression (eight patients), and combined anterior and posterior decompression (five patients).
There were no iatrogenic injuries of great vessels, trachea, esophagus or spinal cord. All patients were followed up for 15-86 months (average, 38.3 months). All segment with anterior fixation attained solid fusion, without implants loosening or breakage. No reclosed open-door was found after posterior laminoplasty. Twenty-one patients improved by one to two Frankel grades. The patients with complete spinal cord injury achieved no neurologic recovery, but did experience relief of upper limb pain or numbness.
The surgical outcomes of cervical cord injury with ossification of the posterior longitudinal ligament were satisfactory. It is important to select a suitable surgical approach according to the findings on radiological imaging and the clinical characteristics and general condition of the patients.
探讨颈椎后纵韧带骨化并发脊髓损伤的手术治疗方法。
回顾性分析 25 例颈椎后纵韧带骨化并发脊髓损伤患者的临床资料，Frankel 分级：A级 2 例，B 级 3 例，C 级 14 例，D 级 6 例。手术方式：前路减压固定融合术 12 例，后路减压术 8 例，前后路联合手术 5 例。
手术过程中未出现大血管、气管、食管及脊髓损伤等并发症。术后随访 15～86 个月，平均 38.3 个月。所有前路固定节段均骨性融合，无内固定松动、断裂。后路单开门椎管扩大成形术后无再关门现象发生。术后按 Frankel 分级评定：21 例患者神经功能恢复 1～2 级。完全性脊髓损伤患者神经功能无恢复，但上肢疼痛及麻木症状均有不同程度缓解。
颈椎后纵韧带骨化并发脊髓损伤的手术疗效满意，应根据影像学表现、临床特点及患者一般状况选择合适的手术方式。
