胸椎黄韧带骨化基础与临床研究进展  

Current basic and clinical research on thoracic ossification of ligament flavum:a literature review

作　　者：宁尚龙[1,2] 陈仲强[1] 马信龙[2] 张晓林[2] 苗军[2] 

机构地区：[1]北京大学第三医院骨科,北京100091 [2]天津医院脊柱外科,天津300211

出　　处：《中国矫形外科杂志》2017年第11期999-1004,共6页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目(编号:81071505;81272031;81572101)

摘　　要：临床上,胸椎黄韧带骨化(TOLF)是引起胸椎管狭窄最常见、最重要的原因,近年来逐渐得到国内外学者的关注而成为骨科的一个研究热点。流行病学研究显示其多发生于亚洲黄种人,发病机制尚不明确。文献报道了各种致病因素,包括遗传,局部损伤和力学因素,慢性退变,内分泌、微量元素异常及饮食代谢异常等。TOLF往往合并椎间盘突出或后纵韧带骨化等颈、胸、腰椎疾患,且病变分布节段也存在变化,可发生于1节至全胸椎,故其临床表现复杂,容易漏诊和误诊。治疗上手术切除骨化病灶是唯一有效的手段。TOLF压迫胸脊髓时临床症状重,若不及时手术减压挽救神经功能,预后较差。手术过程中脊髓损伤风险亦较大,可给患者带来灾难性后果。因此对该病的病因、诊断、治疗方案、疗效预后的认识有待深入探讨。本文将对该病基础和临床研究进展作一综述。Thoracic ossification of ligament flavum （TOLF） occurs mostly in the Asian yellow race. The pathogenesis remains unclear. Literatures have reported various pathogenic factors, including genetics, local damage and mechanical factors, chronic degeneration, abnormal internal secretion or microelement, as well as abnormal diet or metabolism, and so on. TOLF is often accompanied by neck and lumbar vertebra diseases like disc herniation, ossification of posterior longitudinal ligament and other cervical or thoracolumbar diseases. The lesion segments vary, which means it can affect one segment of the thoracic vertebra, or the whole of it. Therefore, the clinical manifestation is complicated, which leads to possible missed diagnosis or diagnostic errors. If the surgery hasn＇ t been operated in time to release the compression and save the neurological function, the prognosis is poor. This paper is a review on recent basic and clinical studies on this disease.

关 键 词：黄韧带 异位性骨化 胸椎 治疗结果 黄韧带骨化 发病机制 

分 类 号：R681.5[医药卫生—骨科学]