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| 颈椎前路椎体骨化物复合体前移融合术治疗严重颈椎后纵韧带骨化症 |
| 孙璟川,史建刚*,王元,徐锡明,孔庆捷,韩郸,郑冰,杨勇,王海波,王英杰,杨海松,郭永飞,黄震,史国栋,蒋京京,陈德玉,袁文,贾连顺 |
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(第二军医大学长征医院脊柱二科, 上海 200003
*通信作者) |
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| 摘要: |
| 目的 报道一项治疗严重颈椎后纵韧带骨化症的新技术，可在不切除骨化物的前提下实现神经的直接减压，弥补传统前路或后路减压手术的不足。方法 颈椎前路椎体骨化物复合体前移融合术的手术操作步骤主要包括处理椎间隙、去除椎体前部骨质、安装钛板和椎间融合器、椎体两侧开槽和椎体骨化物复合体前移等。收集2例经该术式治疗的严重颈椎后纵韧带骨化症患者的临床资料并进行分析。结果 颈椎前路椎体骨化物复合体前移融合术通过将椎体骨化物复合体游离并前移，实现脊髓和神经根的直接减压。2例患者手术顺利，脊髓减压彻底，神经功能恢复良好，无特殊并发症发生。结论 颈椎前路椎体骨化物复合体前移融合术的设计兼顾了前路直接减压的有效性和后路间接减压的安全性，初步疗效证明其可作为严重颈椎后纵韧带骨化症的一种治疗方案。 |
| 关键词: 颈椎病 后纵韧带骨化 前路椎体骨化物复合前移融合术 前路手术 |
| DOI：10.16781/j.0258-879x.2017.08.1053 |
| 投稿时间：2017-08-15修订日期：2017-08-17 |
| 基金项目:国家自然科学基金（81650031），上海市卫生和计划生育委员会项目（201640262）. |
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| Anterior controllable anteriodisplacement and fusion for treatment of severe cervical ossification of posterior longitudinal ligament |
| SUN Jing-chuan,SHI Jian-gang*,WANG Yuan,XU Xi-ming,KONG Qing-jie,HAN Dan,ZHENG Bing,YANG Yong,WANG Hai-bo,WANG Ying-jie,YANG Hai-song,GUO Yong-fei,HUANG Zhen,SHI Guo-dong,JIANG Jing-jing,CHEN De-yu,YUAN Wen,JIA Lian-shun |
(Department of Spine Surgery (Ⅱ), Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| Objective To report a novel technique named anterior controllable antedisplacement and fusion (ACAF) for the treatment of severe ossification of the posterior longitudinal ligament of the cervical spine, which allows for direct decompression of the nerve without resection of the ossification, making up for deficiencies in traditional anterior or posterior decompression. Methods The main surgical procedures of the ACAF included treatment of intervertebral space, removal of the anterior part of vertebrae, installation of titanium plate and interbody fusion cages, bilateral osteotomies of the vertebrae, and antedisplacement of the vertebrae ossification complex. The clinical data of two patients undergoing this surgery for severe ossification of the posterior longitudinal ligament of cervical spine were collected and analyzed. Results ACAF enabled direct decompression of spinal cord and nerve root through antedisplacement of the vertebrae ossification complex. The two patients who underwent ACAF gained satisfactory restoration with decompression of spinal cord and good recovery of neurological function, with no specific complications. Conclusion ACAF surgery takes into account the effectiveness of anterior direct decompression and the safety of posterior indirect decompression. Preliminary results shows that it can be used for severe cervical ossification of the posterior longitudinal ligament. |
| Key words: cervical myelopathy ossification of the posterior longitudinal ligament anterior controllable antedisplacement and fusion anterior surgery |
