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时间:2020-04-27
《颈前路漂浮减压植骨融合内固定术治疗颈椎后纵韧带骨化症疗效观察.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、山东医药2015年第55卷第19期颈前路漂浮减压植骨融合内固定术治疗颈椎后纵韧带骨化症疗效观察12111王瑞,王辉,霍喜卫,胡成栋,刘法敬(1邯郸市中心医院,河北邯郸056001;2邢台矿务局总医院)摘要:目的观察颈前路漂浮减压植骨融合内固定术治疗孤立型颈椎后纵韧带骨化症的临床效果。方法36例孤立型颈椎后纵韧带骨化症患者,接受颈前路漂浮减压植骨融合内固定术治疗。术后观察患者颈椎曲度指数(CCI)、神经功能恢复及相关并发症发生情况。结果所有患者均顺利完成手术,术后未出现神经症状加重及脊髓损伤等情况。手术时间81~1
2、55(116.0±21.3)min。术中出血190~410(227.0±35.5)mL。术后5例患者发生脑脊液漏,经局部加压包扎及腰大池置管引流后均好转。随访时间15~46个月,随访期间未出现内固定物松动、移位、脱出等情况。术后患者神经功能均获得明显改善,JOA评分术前为(8.5±2.1)分,术后3个月为(13.0±3.3)分,末次随访时为(13.7±3.6)分,后两者与术前比较,P均<0.05。神经功能改善率为70.1%±13.8%。CCI术前为14.2%±4.3%,术后3d为13.8%±4.6%,末次随访时为
3、12.9%±4.4%,三者比较,差异无统计学意义。结论颈前路漂浮减压植骨融合内固定术治疗孤立型颈椎后纵韧带骨化症能彻底解除脊髓前方的骨性压迫,恢复并重建颈椎生理曲度,效果满意。关键词:颈椎病;后纵韧带骨化症;内固定器;前路减压;脑脊液漏doi:10.3969/j.issn.1002-266X.2015.19.005中图分类号:R681.5文献标志码:A文章编号:1002-266X(2015)19-0014-03Efficacyofanteriorfloatingdecompressionandinternalfi
4、xationintreatmentofcervicalossificationofposteriorlongitudinalligament1WANGRui,WANGHui,HUOXi-wei,HUCheng-dong,LIUFa-jing(1HandanCentralHospital,Handan056001,China)Abstract:ObjectiveToobservetheclinicaleffectsofanteriorfloatingdecompressionandinternalfixationi
5、ntreat-mentofisolatedcervicalossificationofposteriorlongitudinalligament(OPLL).MethodsAtotalof36casesofcervicalOPLLpatientsinisolatedtypeacceptedtheprocedureofanteriorfloatingdecompressioncombinedwithtitaniummeshim-plantandinternalfixation.Thecervicalcurvatur
6、eindex(CCI),postoperativeneurologicalrecoveryandcomplicationswererecordedandanalyzed.ResultsTheoperationwassuccessfulinallpatients,andnoaggravationofneurologicalsymptomsandspinalcordinjurywerefoundafterthesurgery.Theoperativetimewas81-155(mean116.0±21.3)minwi
7、thabloodlossof190-410(mean227.0±35.5)mL.Fivecasesofcerebrospinalfluidleakageoccurredafterthesurgery,andhealedwellafterlocalcompressionandlumbarcatheterdrainage.Duringthefollow-upof15-46months,nointernalfixationloose-ness,dislocationandextrusionhappened.TheJap
8、aneseOrthopedicAssociation(JOA)scalewasimprovedform(8.5±2.1)preoperativelyto(13.0±3.3)threemonthsaftersurgery,and(13.7±3.6)atthefinalfollow-up;significantdifferencewasfoundbetweenthatbefo
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