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1、经后路椎管扩大减压术治疗多节段颈椎后纵韧带骨化症王振宇①孙元②王强①①大连市友谊医院骨科辽宁大连116100②大连市友谊医院手术室辽宁大连116100【摘要】目的研究经后路椎管扩大减压术治疗多节段颈椎后纵韧带骨化症（ossificationoftheposteriorlongitudinalligament,OPLL）的疗效。方法自2006年8月至2011年8月，采用经后路椎管扩大减压术治疗多节段颈椎后纵韧带骨化症27例，其中男19例，女8例，年龄48〜82岁，平均63.6岁。手术前后用日本矫形外科学会（JOA）评分判断神经功能：用疼痛视觉模拟评分（VAS）评价颈肩痫程度。结果所有患
2、者均获随访，随访时间为3个月〜5年，平均18个月。术后JOA评分为13.3（10〜17）分,较术前10.2（5〜14）分有显著改善（"14.72,p<0.01）o术后症状优良率88.9%。仅2例出现C5神经根麻痹，为一过性。术后颈肩痫VAS评分平均为1.9（1〜3）分，较术前5.2（4〜6）分明显缓解（L14.25,p<0.01）o结论经后路椎管扩大减压术能使脊髓彻底减压，充分后移，避免C5神经根麻痹，是冃前治疗该病的较好方法。【关键词】颈椎;后纵韧带、骨化;减压术,外科Posteriorcervicalenlargedlaminectomyformultisegmentalossi
3、ficationoftheposteriorlongitudinalligamentWANGZhen-yu,SUNYuan,WANGQiang.Departmentoforthopaedics,DalianFriendshipHospital,Dalian116100,China.[Abstract]ObjectiveTostudytheresultsofposteriorcervicalenlargedlaminectomyformultisegmentalossificationoftheposteriorlongitudinalligament.MethodsTotally27
4、patientswithmultiscgmcngtalcervicalOPLLweretreatedbyposteriorcervicalenlargedlaminectomyfromaugust2006toaugust2011.Therewere19malesand8females,withanaverageageof63.6years(ranged,48-82ycars).JOAscoringsystemandthevisualanaloguescale(VAS)scoringwereappliedtoevaluatetheneurologicalfunctionandncck/
5、shouldcrpainrespectively.ResultsAlleaseswerefollowedupfor3monthsto5ycars(avcragc18months).JOAscorehasimprovedfrom10.2(5-14)prcopcrativclyto13.3(10-17)postopcrativcly(t=14.72,p<0.01).Thcexcellentandgoodratewas88.9%.ThcpalsyofC5nerverootoccurredinonly2paticnts.bothrecoveredaftersurgcry.Thcmeanpos
6、toperativeVASscorewas1.9(1-3),comparingwiththeprcopcrativcscore5.2(4-6).Thcpaininncck/shouldcrwasalleviatedobviously(t=14.25,p<0.01)・ConclusionPosteriorcervicalenlargedlaminectomyisaneffectivemethodintreatingmultisegmentalcervicalOPLL.intermsofsignificantposctcriorshiftfbthespinalcord,reliefofc
7、crvical/shouldcrpainjowcrrateofthepalsyofC5nerveroot.[KeywordsJCcrvicalvertebrae；Ossificationoftheposteriorlongitudinalligament；Decompression,surgical颈椎后纵韧带骨化症（ossi行cationoftheposteriorlongitudinalligament,OPLL）的手术治疗，通常采用颈椎后路减压、开门
