中国临床康复2006，Vol.10Issue(24)：158-160,3.
胸椎黄韧带骨化症外科治疗56例功能恢复相关分析
Correlation analysis of post-operation functional restoration in surgical treatment of 56 patients with ossification of ligamentum fiavum in thoracic spine
卢旭华 1陈德玉 1袁文 1曹新峰 1赵定麟1
作者信息
- 1. 解放军第二军医大学长征医院骨科,上海市,200003
- 折叠
摘要
Abstract
BACKGROUND: It is difficult to conduct the operation of ossification of ligamentum flavum (OLF) in thoracic spine, and the operation needs complecated operative skill, and unmerited disposal tends to worsen neurological dysfunction.OBJECTIVE: To analyze the operative method for OLF of thoracic spineand functional restoration.DESIGN: Case analysis.SETTING: Department of Orthopaedics, Changzheng Hospital, SecondMilitary Medical University of Chinese PLA.PARTICIPANTS: Totally 56 patients with OLF of thoracic spine, whowere treated at the Department of Orthopaedics, Changzheng Hospital fromAugust 1996 to August 2003.METHODS: The operative therapy was performed in all the patients, and the method was determined by the results of MRI and CT examination: ①The 19 patients, whose OLF in thoracic spine was focal type, and range of lesion did not exceed two segments, were treated with simple resection and decompres sion in posterior wall of vertebral canal. ②Fenestration and sledging-allocating manipulation in the whole piece unilateral lamina of vertebra were carried out in 29 cases involving more than 2 segments. ③If coplanar OLF in thoracic spine combined with protrusion of thoracic spine disc or ossification of posterior longitudinal ligament, decompression of posterior midline approach+posterior lateral approach was performed, totally 8 cases.MAIN OUTCOME MEASURES: Post-operation functional restoration was evaluated with Epstein standard, excellent: recovery of sensation and exercise was near to normal; good: spinal cord function was improved significantly, and permitted to walk with brace; fair: small partial restoration of sensory and motor function, unable to walk; bad: Inefficiency or becoming severe.RESULTS: A total of 55 cases were followed up for more than one year and 1 case only for two months after operation. ①Functional restoration: excellent: 39 cases; good: 8 cases; fair: 5 cases; bad: 4 cases. ②Symptom recovery after operation was confirmed by disappearance of tight sensation, reduction of muscular tension, relieving of numbness in order. ③The recovery was rapid for 3 to 6 months after operation. Part of patients' condition was still ameliorating during one year after operation, and rare advancement 2 years later. The recovery of complete paraplegics was bad, so was the severe paraplegia with long history. CONCLUSION: Compressive myelopathy caused by OLF in thoracic spine should be treated in an earlier period by operation. Resection and decompression of posterior wall of thoracic spine and decompression of posterior approach could be choosed according to different condition.关键词
骨化,异位性/外科学/黄韧带/外科学/胸椎分类
医药卫生引用本文复制引用
卢旭华,陈德玉,袁文,曹新峰,赵定麟..胸椎黄韧带骨化症外科治疗56例功能恢复相关分析[J].中国临床康复,2006,10(24):158-160,3.
