临床医学论文颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及治疗

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1、临床医学论文-颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及治疗【摘要】探讨颈椎后纵韧带骨化症伴发育性椎管狭窄的临床特点及其治疗｛方法〕对76例颈椎后纵韧带骨化症患者的临床资料进行回顾性分析。根据原始X线片测量颈椎椎体、椎管矢状径，计算Pavlov比値，根据计算结果将患者分为伴发育性椎管狭窄颈椎后纵韧带骨化症组（DSS组）和不伴发育性椎管狭窄颈椎后纵韧带骨化症组（NDSS组）。根据CT分别测量两组骨化灶最大厚度，计算椎管矢状径残存率。其中前路手术4例，后路手术72例，按JOA标准评分判断术后改善率。〔结果〕DS

2、S组53例，NDSS组23例；NDSS组骨化灶最大厚度比DSS组大，有统计学意义；发病时两组椎管矢状径残存率有差异，但是无统计学意义；两组术前、术后3个月JOA评分有差别，但是无统计学意义。〔结论〕发育性椎管狭窄是影响颈椎后纵韧带骨化症病程的重耍病理基础，创伤是诱发其发病的主要因素，后路减压术是一种较合理的治疗方式。【关键词】颈椎后纵韧带骨化发育性椎管狭窄创伤手术治疗Abstract:(Objective]Todiscussclinicfeatureandtreatmentofossificationofcer

3、vicalposteriorlongitudinal1igamentassociatedwithdevelopmentalspinalstenosis・〔Method〕Theclinicdataof76patientswithossificationofcervicalposteriorlongitudinal1igamentwerereviewedandanalyzed・Mcasuringthemiddlesagittaidiameterratioofvertebralcanalandvertebralbod

4、ybytheoriginallateralcervicalvertebraXrayandcalculatingPavlovratio.Al1theenrolledpatientsweredividedintotwogroups:DSSgroupconsistedof53patientsassociatedwithdevelopmentalspinalstenosis,NDSSgroupconsistedof23patientswithoutdevelopmentalspinalstenosis・Measurin

5、gthebiggestthicknessofossificationfocusandtheresidualsagittaldiameterofthespinalcanalrateatthenarrowestlevelattributabletoOPLL.4ofthemweredecompressedfromananteriorapproachand72fromaposteriorapproach.TheimprovementrateaccordingtoJOAscoringwereevaluated.(Resu

6、lt〕DSSgroupconsistedof53patients,NDSSgroupconsistedof23patients.Thebiggestthicknessofossificationfocus,NDSSgroup>DSSgroup,withstatisticalsignificance.Theresidualsagittaidiameterofthespinalcanalrateatthenarrowestlevel,NDSSgroup>DSSgroup,althoughwithoutstatist

7、icalsignificance.JOAscoreoftwogroupsbeforeandaftersurgerywithoutstatisticalsignificance・〔Conclusion〕Developmentalspinalstenosisispathologyfound,whichinfluencescourseofossificationofcervicalposteriorlongitudinal1igament.Theprincipalfactoristrauma,whichinduces

8、ossificationofcervicalposteriorlongitudinalligament.Decompressedfromaposteriorapproachisareasonabletreatmentway.Keywords:cervicalspine;ossificationofcervicalposteriorlongitudinalligament;develop