K线用于选择颈椎后纵韧带骨化症手术策略的回顾性分析

被引:17
作者
陈超
王岩
张雪松
肖嵩华
张永刚
刘郑生
王征
毛克亚
机构
[1] 解放军总医院骨科
关键词
后纵韧带骨化症; 脊髓病; K线; 手术方式;
D O I
暂无
中图分类号
R687.3 [骨骼手术];
学科分类号
100220 [骨科学];
摘要
目的:验证颈椎侧位X线片上C2与C7椎管中点的连线(K线)用于颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)手术方式选择的作用。方法:2000年5月至2008年4月,我科通过后路减压手术治疗颈椎OPLL引起的脊髓病患者35例,男25例,女10例,手术时平均年龄为54.6岁(35~73岁)。根据OPLL范围相对于K线的位置,将所有患者分为两组,OPLL范围未超过K线者为K线阳性组,超过K线者为K线阴性组。记录术前及术后1年时两组患者的日本骨科学会(Japanese Orthopedic Association,JOA)评分,算出恢复率。结果:K线阳性组24例,K线阴性组11例。K线阳性组的JOA评分由术前平均8.6分提高到术后1年时的13.8分,平均提高5.2分;K线阴性组由术前的6.6分提高到术后1年时的9.8分,平均提高3.2分;K线阳性组的平均恢复率为64.2%,K线阴性组为30.8%,两组间有非常显著性差异(P<0.001)。结论:术前利用K线这一简单实用的指标能有效预测OPLL后路减压手术的疗效,从而帮助医生选择合适的手术方式。
引用
收藏
页码:836 / 839
页数:4
相关论文
共 10 条
[1]
颈椎后纵韧带骨化症 [J].
李云恺 ;
王惠 ;
左金良 .
生物骨科材料与临床研究, 2005, (02) :24-26
[2]
前路飘浮法治疗颈椎后纵韧带骨化症初步报告 [J].
刘郑生 ;
王岩 ;
王俊生 ;
肖嵩华 ;
张永刚 ;
侯克东 .
中国矫形外科杂志, 2004, (11)
[3]
A New Concept for Making Decisions Regarding the Surgical Approach for Cervical Ossification of the Posterior Longitudinal Ligament The K-Line [J].
Fujiyoshi, Takayuki ;
Yamazaki, Masashi ;
Kawabe, Junko ;
Endo, Tomonori ;
Furuya, Takeo ;
Koda, Masao ;
Okawa, Akihiko ;
Takahashi, Kazuhisa ;
Konishi, Hiroaki .
SPINE, 2008, 33 (26) :E990-E993
[4]
Anterior corpectomy and fusion for severe ossification of posterior longitudinal ligament in the cervical spine [J].
Chen, Yu ;
Chen, Deyu ;
Wang, Xinwei ;
Lu, Xuhai ;
Guo, Yongfei ;
He, Zhimin ;
Tian, Haijun .
INTERNATIONAL ORTHOPAEDICS, 2009, 33 (02) :477-482
[5]
Surgical strategy for cervical myelopathy due to ossification of the posterior longitudinal ligament part 1: Clinical results and limitations of laminoplasty [J].
Iwasaki, Motoki ;
Okuda, Shin'ya ;
Miyauchi, Akira ;
Sakaura, Hironobu ;
Mukai, Yoshihiro ;
Yonenobu, Kazuo ;
Yoshikawa, Hideki .
SPINE, 2007, 32 (06) :647-653
[6]
Surgical strategy for cervical myelopathy due to ossification of the posterior longitudinal ligament part 2: Advantages of anterior decompression and fusion over laminoplasty [J].
Iwasaki, Motoki ;
Okuda, Shin'ya ;
Miyauchi, Akira ;
Sakaura, Hironobu ;
Mukai, Yoshihiro ;
Yonenobu, Kazuo ;
Yoshikawa, Hideki .
SPINE, 2007, 32 (06) :654-660
[7]
Spinal canal size in ossification of the posterior longitudinal ligament of the cervical spine [J].
Koyanagi, I ;
Imamura, H ;
Fujimoto, S ;
Hida, K ;
Iwasaki, Y ;
Houkin, K ;
Maiman, DJ .
SURGICAL NEUROLOGY, 2004, 62 (04) :286-291
[8]
Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy [J].
Suda, K ;
Abumi, K ;
Ito, M ;
Shono, Y ;
Kaneda, K ;
Fujiya, M .
SPINE, 2003, 28 (12) :1258-1262
[9]
Morphologic limitations of posterior decompression by midsagittal splitting method for myelopathy caused by ossification of the posterior longitudinal ligament in the cervical spine [J].
Yamazaki, A ;
Homma, T ;
Uchiyama, S ;
Katsumi, Y ;
Okumura, H .
SPINE, 1999, 24 (01) :32-34
[10]
Anterior decompression and fusion using bone grafts obtained from cervical vertebral bodies for ossification of the posterior longitudinal ligament of the cervical spine: Technical note [J].
Isu, T ;
Minoshima, S ;
Mabuchi, S .
NEUROSURGERY, 1997, 40 (04) :866-869