局麻后路椎板切除减压治疗胸椎黄韧带骨化症Treatment of thoracic ossification of ligamentum flavum with decompressive laminectomy under local anesthesia
陈晓庆;杨惠林;王根林;潘文明;顾勇;梅昕;唐天驷;
摘要(Abstract):
[目的]探讨局麻下应用后路椎板切除减压治疗胸椎黄韧带骨化症的疗效。[方法]2004年6月~2007年12月,16例胸椎黄韧带骨化症患者,在局麻下采用后路椎板切除减压治疗,其中男10例,女6例;平均50.5岁(33~69岁);单节段4例,多节段12例。[结果]平均手术时间180min(125~250min);平均失血量360ml(230~530ml);平均每例减压2.9个椎板(1~9个)。全部病例随访6~48个月,平均28.6个月。术前JOA评分为4.812±1.109,术后JOA评分为8.313±1.702,两者比较差异有统计学意义(t=10.63,P<0.01),JOA恢复率58.6%,疗效优良率81.3%,总有效率93.8%。所有病例无后凸畸形、慢性背痛等并发症。[结论]临床表现结合影像学检查是诊断胸椎黄韧带骨化症的重要手段。局麻下后路椎板切除减压可有效缓解临床症状,改善功能,可以取得满意的疗效。减压后并不一定需要椎管成形。
关键词(KeyWords): 骨化;黄韧带;胸椎;脊髓压迫症;减压术;局麻
基金项目(Foundation):
作者(Author): 陈晓庆;杨惠林;王根林;潘文明;顾勇;梅昕;唐天驷;
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DOI:
参考文献(References):
- [1]陈仲强.共同努力,提高胸椎黄韧带骨化症的诊治水平[J].中华骨科杂志,2007,1:1-2.
- [2]Aizawa T,Sato T,Sasaki H,et al.Thoracic myelopathy caused by os-sification of the ligamentum flavum:clinical features and surgical re-sults in the Japanese population[J].J Neurosurg Spine,2006,5:514-519.
- [3]Pascal-Moussellard H,Cabre P,Smadja D,et al.Symptomatic ossifi-cation of the ligamentum flavum:a clinical series from the French An-tilles[J].Spine,2005,30:400-405.
- [4]Okada K,Oka S,Tohge K,et al.Thoracic myelopathy caused by ossi-fication of the ligamentumflavum.Clinicopathologic study and surgical treatment[J].Spine,1991,16:280-287.
- [5]左文山,高聿同,戴志唐,等.半关节突全椎板切除原位回植法治疗胸椎黄韧带骨化症[J].中国矫形外科杂志,2005,9:662-663.
- [6]Mika A,Unnithan VB,Mika P.Differences in thoracic kyphosis and in back muscle strength in women with bone loss due to osteoporosis[J].Spine,2005,30:241-246.