胸椎管狭窄症诊断及手术治疗（附32例报告）  

Diagnosis and Surgical Treatment of Stenosis ofThoracic Vcrtcbral Canal:A Report of Thirty-twoCascs

作　　者：赵合元[1] 周静[1] 艾国礼 王介民[1] 秦学敏[1] 冯大生 

机构地区：[1]天津医院骨病科,石家庄地区医院

出　　处：《中华骨科杂志》1995年第12期825-827,共3页Chinese Journal of Orthopaedics

摘　　要：作者报道胸椎管狭窄引起胸髓压迫症３２例，表现为肌张力改变，括约肌功能障碍，皮肤感觉异常，不完全截瘫及完全截瘫。其诱发因素包括脊柱退行性变１６例，氟骨症１１例，外伤后继发２例，Ｏ－ＰＬＬ３例。其影像学检查具特征性表现，脊髓造影、ＣＴ及手术发现狭窄均发生在椎间关节一间盘水平。３２例均行全椎板切除减压术，包括切除部分小关节。减压长度超过病变范围上下各一个椎板，宽度超过正常硬膜囊的横径。随访２９例，平均随访时间５０个月。有效率８２．７％。早期明确诊断，及时手术治疗可获得较满意的疗效。AbstractThirty two cases of thoracic spinal cordcompres-sion resulting from stenosis of the thoracic vertebralcanal are reported.The clincal manifestations werechanges of the muscular tension, sphincter dysfunc-tion,paresthesia and complete or incomplete paragle.gia. The precipitating causes included retrograde de-genertaion of the spinal column in 16 cases,fuorosis in11 cases,diseases secondary to trauma in 2 cases andOPLL in 3 cases,Both myelography and CT demon- strated the sites of stenosis at the level of interverte-bral articulations,i.e. the level of the intervertebraldisc. These findings were also confirmed duringsurgery, Complete laminectomy decompression wereperformed in all 32 cases; the procedure included par-tial removal of one lamina above and below the lesionin the longitudinal direction and the transverse diame-ter of the normal dura matter in the transverse direc-tion. 29 csaes were followed-up for an average of 50months after surgery. The effective rate was 82.7%. Early diagnosis and prompt su rgical management arethe key points for a satisfactorv outcome.

关 键 词：胸椎管狭窄症 诊断 外科手术治疗 

分 类 号：R681.5[医药卫生—骨科学]