孤立型胸椎黄韧带骨化并椎管狭窄的诊治

The Diagnosis and Treatment for Thoracic Myelopathy Caused by Isolated Ossification of Ligamentum Flavum

研究孤立型胸椎黄韧带骨化(OLF)并椎管狭窄诊断与手术治疗的特点。采用回顾性研究方法对手术治疗的孤立型胸椎OLF病例进行总结分析。手术方法采用椎板间开窗减压术与椎管后壁切除减压术。按改良胸椎JOA评分,术前评分7～8分,平均7.7分。结果术后随访平均14.3个月,参照Ep stein所定标准:优6例,良2例,改善1例。术后胸椎JOA评分8～11分,平均10.2分。孤立型OLF临床表现复杂,仔细查体结合CT、MRI检查是诊断OLF的重要手段。通过三维CT确定骨化部位,椎板间开窗减压术是治疗孤立型OLF并椎管狭窄的有效方法。

To study the characteristics of diagnosis and surgical treatment for thoracic myelopathy caused by isolated ossification of ligamentum flavum （OLF）. From 2003 to 2005, 9 cases of OLF treated stirgically by laminectomy or partial lamincctomy were studied retrospectively. The preoperative average JOA scale score was 7. 7points （range from 7 to 8 points）. All of the patients were followed up from 4 months to 27 months with an average of 14. 3 months. According to Epstein assessing system, 6 patients achieved good, 2 patients were improved, lbetter. The postoperative average JOA scale score was 0. 2points （range from 8 to 11 points）. Clinical history and neurological examination associated with MRI and CT is the important means of the diagnosis of OLF, partial laminectony at the affected level is effetive and less invasive.