Isu T, Mabuchi S, Minoshima S, Nakayama N
Department of Neurosurgery, Kushiro Rousai Hospital.
No Shinkei Geka. 1994 Sep;22(9):839-44.
The surgical results in 37 patients with cervical myelopathy due to ossification of the posterior longitudinal ligament of the cervical spine were described. This series consisted of 32 patients who underwent anterior decompression with anterior cervical fusion using bone grafts obtained from cervical vertebral bodies, and 5 patients who underwent expansive laminoplasty or laminectomy as a method of posterior decompression. 6 out of 32 patients with anterior cervical fusion were operated on at one level, 18 at two levels and 8 at three levels. The patients were out of bed within two days and treated using a soft collar for 3 months. In all patients, the symptoms improved postoperatively. Postoperative X-ray films showed solid bone fusion in all patients with anterior cervical fusion at a mean follow up time of one year and nine months (range 6 months to 3 years 6 months). Anterior angulation was found in one (3%) out of 32 patients who underwent anterior cervical fusion. Concerning the method of operation, the authors think that anterior decompression is to be recommended for cases with ossification within three consecutive vertebrae and posterior decompression should be applied to cases in which anterior decompression is very difficult. If necessary, a two-stage combined decompression is recommended.
本文描述了37例因颈椎后纵韧带骨化导致的脊髓型颈椎病患者的手术结果。该系列包括32例行前路减压并取自颈椎椎体的骨块进行颈椎前路融合术的患者，以及5例行扩大椎板成形术或椎板切除术作为后路减压方法的患者。32例行颈椎前路融合术的患者中，6例在一个节段进行手术，18例在两个节段进行手术，8例在三个节段进行手术。患者术后两天内即可下床，并使用软颈托治疗3个月。所有患者术后症状均有改善。术后X线片显示，在平均随访时间为1年9个月（范围6个月至3年6个月）时，所有行颈椎前路融合术的患者均实现了牢固的骨融合。32例行颈椎前路融合术的患者中有1例（3%）出现了前凸畸形。关于手术方法，作者认为对于连续三个椎体出现骨化的病例，建议采用前路减压，而对于前路减压非常困难的病例，则应采用后路减压。如有必要，建议采用两阶段联合减压。
