摘要
目的探讨采用经胸椎椎间孔椎间融合术治疗胸椎间盘突出症的疗效和安全性。方法对本院2007年2月～2011年2月手术治疗的胸椎间盘突出症患者21例,其中男15例,女6例,年龄19～65岁,平均年龄45.5岁,病程为1个月～3年,平均1.7年,均选择经胸椎椎间孔椎间融合术治疗。采用日本骨科协会(JOA)评分(11分法)和Otani分级标准进行疗效评定。结果手术时间2.0～5.0 h,平均3.5 h;出血量400～2 400 mL,平均800 mL,患者均获得随访,随访时间0.6～4.6年,平均3.1年。术前JOA评分2～9分,平均(5.3±2.2)分,末次随访评分3～11分,平均(8.4±1.6)分,两者比较差异有显著性。术后神经功能恢复率10%～90%,其中优9例(42.9%),良8例(38.1%),可4例(19.1%),优良率为81%,根据Otani分级标准,其中优9例,良6例,一般4例,差2例,总优良率71.4%。术后无1例出现胸椎不稳及神经症状加重等并发症。结论经胸椎椎间孔椎间融合术治疗胸椎间盘突出症临床效果良好,并能减少并发症发生。
【Objective】 To evaluate the clinical results of the surgical treatment via transforaminal thoracic interbody fusion approach for thoracic disc herniation.【Methods】 Selecting the 21 thoracic disc herniation patients who treated in our hospital from February 2007 to February 2011.These patients were all treated with transforaminal thoracic interbody fusion method.There were 15 males and other 6 females.The patients were from 19 years old to 65 years old,and the mean age was 45.5 years old.The course of disease ranged from 1 month to 3 years,and 1.7 years for average.The surgical outcomes were evaluated with preoperative and postoperative thoracic Japanese Orthopaedic Association（JOA） score;Otani scored system to evaluate the clinical results.【Results】 The operative time was 2.0～5.0 h,with average of 3.5 h.The blood loss was 400～2400 mL,with average of 800 mL.The patients following-up times were from 0.6 to 4.6 years,and 3.1 years for average.The average preoperative JOA score was 2～9（average 5.3±2.2）,which significantly increased to 3～11（average 8.4±1.6） in the last follow-up.Postoperative neurologic functional recovery rates were 10%to 90%,including excellent in 9 eases,good in 8,fair in 4.The excellent or good rule was 81%.According to Otani scored system,there were excellent in 9 cases,good in 8 cases,fair in 4 and poor results in 2 case.The clinical satisfaction rate was 71.4%.No clinical or radiographic features of instability,nervous symptoms and wound infection were found.【Conclusion】 The posterior midline approach with transforaminal thoracic interbody fusion operation can produce good results and can reduce the complications in treating patients with thoracic disc herniation.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2012年第24期71-75,共5页
China Journal of Modern Medicine
关键词
胸椎
椎管狭窄
椎间盘切除术
椎间盘移位
thoracic vertebrae
spinal stenosis
diskectomy
intervertebral disk displacement
