后路全椎板减压＋胸椎弓根钉内固定术治疗胸椎黄韧带骨化的疗效分析

Omni - posterior decompression and transpedicular screw fixation in thoracic spine for thoracic os- sification of ligamentum flavum

目的探讨后路全椎板减压＋胸椎弓根钉内固定术治疗胸椎黄韧带骨化的疗效。方法回顾性总结2002年至2008年间胸椎黄韧带骨化病例27例。患者术前均常规给予X线、CT及MRI检查。手术采用后路全椎板减压＋椎弓根钉内固定术。术后采用改良Macnab疗效评定标准及VAS评分，评价治疗效果。结果术后改良Macnab疗效评定标准，27例患者术后1年内优良率77．8％，手术总有效率85．2％，1年后优良率85．1％。VAS评分应用专用评分尺，患者总满意度为66．6％，1年后总满意度为75％。结论后路全椎板减压＋胸椎弓根钉内固定术为治疗胸椎黄韧带骨化安全有效的手术方式。

Objective To examine the clinical efficacy of omni - posterior decompression and transpedicular screw fixation in thoracic spine in the treatment of thoracic ossification of ligamentum flavum. Methods The clinical data of 27 patients with thoracic ossification of flavum who underwent omni - posterior decompression and transpedicular screw fixation in thoracic spine in our hospital from January 2002 to January 2008 were retrospectively analyzed. The patients included 18 males and 9 females at age of 47 to 71 years with an average of 58 years. All of them were given routine X -ray, CT and MRI examina- tions preoperatively. The improved Macnab standard and VAS scoring system were used to evaluate the sur- gical effects. Results According to the Macnab standard,the excellent and good rate was 77.8% in this cohort within one year after operation and the effective rate was 85. 1%. The excellent and good rate reached 85.1% one year after operation. VAS scoring revealed that the satisfactory degree was 66.6% within a year and 75% a year later. The mean follow - up duration was 2.5 year（ 1.5 to 5 years）. Conclusion Omni - posterior decompression and transpedicular screw fixation in thoracic spine is a safe and effective operation method for thoracic ossification of ligamentum flavum.