摘要
目的介绍以改良"揭盖式"椎管后壁切除术治疗胸椎黄韧带骨化症的手术方法,并探讨其疗效。方法自2004年1月～2009年7月对16例胸椎黄韧带骨化症采用改良"揭盖式"椎管后壁扩大切除法。结果术后下肢有轻松感,12例症状立即缓解,4例术后逐渐缓解,无症状加重者;2例发生脑脊液漏,经对症处理后痊愈;2例有相应神经节段的神经刺激症状,1～2个月后缓解,其余无并发症发生。术后4周,2例括约肌功能障碍者术后4周JOA评分为(2.368±0.762)分。和术前(1.284±0.816)分比较,差异有统计学意义(P<0.01);术后4周JOA下肢运动功能评分为(3.178±0.615)分,和术前(1.325±0.528)分比较,差异有统计学意义(P<0.01),恢复率平均85.7%。术后疗效:优12例,良2例,可2例,优良率87.5%。术后16例获得随访0.5～5年,平均26.5个月。末次随访时括约肌功能恢复,下肢运动功能JOA评分为(3.358±0.824)分。结论改良"揭盖式"椎管后壁扩大切除术是治疗胸椎黄韧带骨化症的安全、有效术式。
Objective To introduce the surgical method of total laminectomy with modified ＂cap uncovering＂ in the treatment of ossification of thoracic ligamentum flavum and to explore its therapeutic effects. Methods From January 2004 to July 2009, sixteen patients with ossification of thoracic ligamentum flavum were treated by total laminectomy for posterior decompression of the spinal canal. Results The sixteen patients were successfully operated. The clinical symtoms in 12 cases reliefed immediately after operation, 2 cases reliefed gradually, none with symptom deterioration. Two cases with cerebrospinal fluid leakage were fully recovered at two weeks after operation. Four weeks after operation, JOA score of 2 cases with sphincter dysfunction was （2.368±0.762）, there was statistically significant difference compared to the preoperative score （1.325±0.528） （P 〈0.01）. Statistically significant difference was also observed in the postoperative JOA motor function score （3.178 ：r-0.615） compared to the preoperative score （1.325±0.528） （P 〈0.01）. The motor function recovery rate and the therapeutic effect of excellent and good rate was 85.7% and 87.5% respectively. Sixteen cases were followed up and mean follow-up period was 26.5 months. At the last follow-up, JOA lower limb motor function score was （3.358 ±0.824）. Conclusion The modifed ＂cap uncovering＂ total lamineetomy is a safe and effective surgical method in the treatment of ossification of thoracic ligamentum flflvum.
出处
《中国骨与关节损伤杂志》
2013年第1期16-18,共3页
Chinese Journal of Bone and Joint Injury
关键词
黄韧带骨化症
胸椎
椎板切除术
Ossification of ligamentum flavum
Thoracic vertebrae
Laminectomy
