前路多节段椎体次全切除 治疗严重颈椎后纵韧带骨化症. 陈德玉. 上海市长征医院骨科 上海市脊柱外科中心. OPLL 的流行病学. 日本 1.8%-4.1% 中国 1.6%-1.8% 韩国 0.95% 美国 0.12% 德国 0.1%. From OPLL edited by K Yonnenobu, et al. OPLL 的手术治疗. 后路椎板切除 后路椎管成形术 ( Hirabayashi 1977) 直接切除减压 (Yamaura 1976)
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From OPLL edited by K Yonnenobu, et al
四肢麻木无力 5 年加重半年
MRI showing sufficient decompression of the spinal cord
男 71 岁
X-ray and CT:
C3-C6 OPLL with kyphosis
The change of spinal cord on pre- and post-operative MRI
The A-group had a better JOA score after surgery (13.9vs 10.1 ; P<0.003) and a higher IR (58% vs 13%; P<0.002) than P-group.
(Tani et al. Spine, 2002)
Surgical outcome of anterior decompression and fusion was superior to that of laminoplasty in the patients with occupying rate greater than 60% (54％ vs 14%; P<0.03).
(Iwasaki et al. Spine, 2007)
Excellent or good for 89% were obtained through anterior direct removal of OPLL.
(Mizuno and Nakagawa, The Spine Journal 2006)
Progression of OPLL
MRI in year 2000 and 2007
The neurological status was significantly improvement
MRI pre- and 3 m post-operation
Lateral X-ray: cervical alignment was lordotic
Laminoplasty was performed without function improvement.
X-ray and CT at 2 m postoperatively The cervical alignment was straight.
MRIs after anterior decompression and laminoplasty
Double-layer sign by Hida
Irregular hook-like angle by Epstein
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