Qizhi Sun, Xuelei Wang, Lili Yang, Lei Liang, Linwei Chen, Yang Liu, Ying Zhang, Wen Yuan
Department of Orthopedics, No. 88 Hospital of China People’s Liberation Army, Shandong, China.
Orthopedics. 2012 Mar 7;35(3):e403-8. doi: 10.3928/01477447-20120222-38.
The purpose of this study was to evaluate the outcome of segmental anterior decompression and fusion for multilevel ossification of the posterior longitudinal ligament. Data were collected from 23 patients with multilevel ossification of the posterior longitudinal ligament. Average operative time and blood loss were 121 minutes and 201.6 mL, respectively. The Nurick score significantly decreased from 2.7±0.9 preoperatively to 1.8±0.9 at last follow-up (P<.01). The preoperative Japanese Orthopaedic Association score was 8.2, which significantly increased to 13.8 points at last follow-up (P<.01), with an improvement rate of 64.5%. The operation also significantly increased cervical lordosis (P<.01) from 7.7° preoperatively to 13.3° postoperatively. The fusion rate was 95.7% at 6 months postoperatively, and 100% at 12 months postoperatively. The loss of cervical lordosis and height of fusion segments were 1.2° and 0.9 mm at last follow-up, respectively. No hardware complications occurred. Cerebrospinal fluid leakage occurred in 2 patients, and hematoma occurred in 1 patient who needed an emergency operation. Segmental anterior decompression and fusion was generally effective and safe in the treatment of multilevel ossification of the posterior longitudinal ligament if indications were well controlled.
本研究的目的是评估节段性前路减压融合术治疗多节段后纵韧带骨化症的疗效。收集了23例多节段后纵韧带骨化症患者的数据。平均手术时间和失血量分别为121分钟和201.6毫升。Nurick评分从术前的2.7±0.9显著降至末次随访时的1.8±0.9（P<0.01）。术前日本骨科协会评分为8.2分，末次随访时显著提高至13.8分（P<0.01），改善率为64.5%。手术还使颈椎前凸显著增加（P<0.01），从术前的7.7°增至术后的13.3°。术后6个月融合率为95.7%，术后12个月为100%。末次随访时融合节段的颈椎前凸丢失和高度分别为1.2°和0.9毫米。未发生内固定并发症。2例患者发生脑脊液漏，1例患者发生血肿，需要急诊手术。如果严格掌握适应证，节段性前路减压融合术治疗多节段后纵韧带骨化症总体有效且安全。
