胸椎黄韧带骨化症的手术治疗

Operative treatment of ossification of ligamentum flavum in thoracic spine

目的 :回顾性地研究了 32例胸椎黄韧带骨化症 (TOL F)的手术治疗方法及结果。方法 :对 1989～ 1999年收治的 32例 TOL F患者所施的手术方法及临床结果进行描述。结果 :全部病例术后病理检查 ,均符合 TOL F。 30例获随访 ,随访时间 5～ 72月 ,平均 32月 ,根据下肢感觉和运动功能恢复情况进行评价 ,优 11例 ,良 10例 ,可 7例 ,差 2例 ,优良率 73.3% ,有效率 93.3%。结论 :早期减压是治疗 TOL F的唯一有效方法 ,后路全椎板切除减压术是治疗单纯 TOL F最常用而有效的术式 ,对于合并 TDH或 OPL L 患者 ,后路全椎板减压加侧后方入路脊髓前方减压是简单实用的术式。

Objective:Operative methods and results of 32 cases of ossification of ligamentum flavum in thoracic spine (TOLF) were studied retrospectively.Methods:Operative methods and clinical results of 32 cases of TOLF which were treated between 1989 and 1999 were described.Results:The pathological reports of all the cases supported the diagnosis of TOLF 30 cases were followed,the follow-up time from 5 to 72 months,average 32 months.According to the function recovery of sense and motion of the limbs,good result rate was 73.3%,efficient rate was 93.3%.Conclusion:Early decompression is the only effective method for TOLF.Posterior total laminectomy is a easy and effective operation.Posterior total laminectomy plus posterior lateral approach disc excision is an available method for treating TDH accompanied by TOLF.