黄韧带骨化胸椎管狭窄脊髓受压的手术治疗  

作　　者：李永军[1] 刘明勋 吕志刚[1] 王广超[1] 

机构地区：[1]济源市第二人民医院骨科 [2]解放军71620部队卫生队

出　　处：《当代医学》2015年第20期42-43,共2页Contemporary Medicine

摘　　要：目的 探讨黄韧带骨化胸椎管狭窄脊髓受压的手术治疗方法和疗效。方法 选择16例胸椎管黄韧带骨化致椎管狭窄症患者,均采用后路椎管分层薄化切除减压钉棒系统内固定并后外侧植骨融合的手术方法进行治疗。术后手术疗效采用日本骨科协会（Japanese Orthopedic Association,JOA）评分进行评价。结果 术后患者均获得随访,末次随访时患者束带感均消失,11例下肢麻木、无力、疼痛完全消失,4例部分消失,1例无明显恢复。术前JOA评分平均（4.2±2.5）分,术后平均（7.8±1.9）分。术后恢复率为33.3%~100%,16例中优8例,良4例,可4例,优良率75%。所有病例内固定位置良好,植骨融合,无松动及假关节形成。结论 采用后路椎管分层薄化切除减压钉棒系统内固定并后外侧植骨融合治疗胸椎管黄韧带骨化胸椎管狭窄症,手术安全可靠,疗效确切。Objective To explore the method and effect of operation treatment of thoracic ossification of ligamenttma flavum stenosis of spinal cord compression tube. Methods 16 cases of thoracic spinal ossification of ligamentum flavum （OLF） caused by spinal stenosis patients, using thin layer of posterior vertebral resection and decompression screw rod system fixation and posterolateral grafting bone fusion surgery method treatment. The clinical effect of Orthopaedic Association Japanese （JOA） was evaluated by the clinical effect of the operation. Results Postoperative patients were followed up for 18 months to 6 years, an average of 22 months.Last follow-up of patients belted a sense disappeared, 11 cases of lower extremity numbness, weakness,pain completely disappeared in 4 cases part of the disappeared, and 1 case had no significant recovery. Preoperative JOA score from 1 to 9 points, the average （4.2 ± 2.5） points; after the last follow-up of 5 to 11 minutes, the average （7.8 ± 1.9） points. Postoperative recovery rate of 33.3% to 100%, 16 cases were excellent in 8 cases, good in 4 cases, 4 cases, good rate of 75%. Last follow-up showed good position of fixation in all cases, fusion, and no loose pseudarthrosis. Conclusion Using the layered thin posterior spinal surgical decompression screw rod system fixation and posterolateral fusion for the treatment of thoracic ossification of ligamentum flavum of thoracic spinal stenosis of canal operation, safe and reliable, curative effect.

关 键 词：胸椎 黄韧带 椎管狭窄 

分 类 号：R687.3[医药卫生—骨科学]