全可视下脊柱内镜技术治疗重度胸椎黄韧带骨化症  

Treatment of severe thoracic ossification of ligamentum flavum with full visual spinal endoscopy

作　　者：郑科[1] 倪志豪 董洲 祁家龙 韩国嵩 单涛 曾宪琦 王善松[1] ZHENG Ke;NI Zhi-hao;DONG Zhou;QI Jia-long;HAN Guo-song;SHAN Tao;ZENG Xian-qi;WANG Shan-song(Department of Spinal Surgery,Hefei First People’s Hospital,Hefei,Anhui 230061,China)

机构地区：[1]合肥市第一人民医院脊柱外科,安徽合肥230061

出　　处：《颈腰痛杂志》2024年第2期268-270,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨全可视下脊柱内镜技术治疗重度胸椎黄韧带骨化症的临床疗效分析。方法2018年1月~2022年12月,应用全可视脊柱内镜技术治疗例重度胸椎黄韧带骨化症患者共16例,男11例、女5例,年龄39~73岁、平均54.5岁;病程4~37个月、平均18.5个月,随访8~36个月。结果患者术前、术后1个月、6个月和末次随访时的胸背痛及下肢痛视觉模拟评分(visual analogue scale,VAS)分别为(7.06±0.85)分、(2.88±0.62)分、(1.81±0.54)分、(1.25±0.45)分,术后各时间段的VAS评分均显著低于术前,差异有统计学意义(P<0.01)。患者术前、3个月和6个月末次随访JOA评分分别为(12.43±1.26)分、(20.69±1.62)分、(23.62±1.20)分、(26.25±1.07)分,术后各时间段的JOA评分均显著优于术前,差异有统计学意义(P<0.01)。患者术前、术后3个月和6个月和末次随访时的Oswestry功能障碍指数(Oswestry disability index,ODI)分别为(68.9±3.3)%、(30.9±2.5)%、(19.0±3.0)%、(13.1±2.9)%。术后1个月、6个月及末次随访时均较术前明显改善(P<0.05)。结论全可视下脊柱内镜技术治疗重度胸椎黄韧带骨化症安全性高、术后恢复快、疗效明确。Objective To investigate the clinical effect of full visual spinal endoscopy in the treatment of severe ossification of the thoracic ligament flavum.Methods From January 2018 to December 2022,a total of 16 patients with severe ossification of the thoracic ligament flavum were treated with fully visible spinal endoscopy,including 11 males and 5 females,aged 39-73 years with an average age of 54.5 years.The duration of the disease ranged from 4 to 37 months,the mean duration was 18.5 months,and the follow-up was 8 to 36 months.Result The VAS scores of the patients were(7.06±0.85),(2.88±0.62),(1.81±0.54)and(1.25±0.45)before,one month,six months and the last follow-up,respectively.The VAS scores at all time periods after surgery were significantly lower than those before surgery,with statistical significance(P<0.01).The JOA scores of the patients were(12.43±1.26)scores,(20.69±1.62)scores,(23.62±1.20)scores and(26.25±1.07)scores at the follow-up visits at the end of three months and six months,respectively.The JOA scores at all time periods after surgery were significantly better than those before surgery,with statistical significance(P<0.01).The ODI of patients with preoperative and postoperative three months and six months and at the end of operation was respectively(68.9±3.3)%,(30.9±2.5)%,(19.0±3.0)%,(13.1±2.9)%,respectively.The one month,six months and the last follow-up were significantly improved compared with those before surgery(P<0.05).Conclusion Full visual spinal endoscopy in the treatment of severe thoracic ossification of ligamentum flavum has high safety,rapid postoperative recovery and clear efficacy.

关 键 词：黄韧带骨化 脊柱内镜 胸椎 

分 类 号：R687.3[医药卫生—骨科学]