【摘要】 目的通过实验观察颈椎后纵韧带的解剖形态,探讨前路手术切除后纵韧带治疗硬膜外型颈椎间盘突出症的手术疗效。方法采集10具颈段脊柱标本,测量C3至C7节段椎体及椎间盘平面后纵韧带的宽度,计算出各个节段95﹪可信区间,对测量结果进行统计学分析。并对2004年1月-2010年12月参照此结果进行颈前路后纵韧带切除手术的42例硬膜外型颈椎间盘突出症病例进行回顾性分析,采用JOA评分评估手术疗效。结果后纵韧带随着椎体宽度变化而变化,在间盘平面和椎体平面其宽度无显著性差异。42例中35例获得随访,平均随访时间19.2月,术后末次随访时JOA改善率优22例,良8例,可4例,差1例,总优良率达85.7﹪,平均改善率74﹪。结论解剖学研究为临床上切除后纵韧带治疗硬膜外型颈椎间盘突出症提供了依据,术中切除适当宽度后纵韧带是完整取出游离间盘并有效减少副损伤治愈该病的必要措施。更多还原

【Abstract】 Objective To oberserve To investigate therapeutic effects of anterior discectomy and intervertebral bone graft fusion for epidural cervical disc extrusion(ECDE) by excising the cervical posterior longitudinal ligament(PLL) according to the result of anatomical research.Methods Whole cervical spinal columns from C2 through C7 were from 10 human adult cadavers of Chinese origin.The segmental widths of cervical PLL were measured under a surgical microscope,and the measuremental results were analysed by statistics softwares.The clinical data of 42 cases Between January 2004 and December 2010 of ECDE operated through anterior approach by excising cervical PLL were reviewed,And the clinical outcome was analysed on the JOA grade method(17 grades).Results The change of the widths of the cervical PLL accompanied with that of the cervical segments,but no differences were detected in PLL widths between the segmental ligments at the vertebral bodies and intervertebral discs on all levels.35 cases were sufficient follow-up in 42 cases.The mean time of follow-up was 19.2(range,3 to 56months).The clinical outcome was graded as execellent in 22 cases,good in 8 cases,effective in 4case,ineffective in 1 case.Totally,85.7 percent of those cases was fine and average improvement rate was 74 percent.Conclusion This investigation suggests that anatomic study provided data of cervical PLL which shoud be excised when curing ECDE by discectomy through anterior approach,which ensure a good outcomes.更多还原