胸椎黄韧带骨化症外科治疗选择及并发症分析（附54例报告）

Surgical treatment and complications of ossification of the thoracic ligamentum flavum ~ report of 54 cases

目的探讨胸椎黄韧带骨化症的临床发病特点与治疗方法的选择及如何减少或避免并发症。方法回顾分析54例胸椎黄韧带骨化症患者的临床资料及外科治疗，分析其发病特点及影像学特征性表现与类型，观察各治疗方法的疗效。结果本组患者术后均获得随访，均超过17个月。术后6个月JOA改善率均〈50％，1年内〈70％，2年内各治疗组效果均达到优或良。结论胸椎黄韧带骨化症一旦确诊应积极手术治疗，根据临床和影像学特点选择手术方式。术后6个月内恢复最快，术后2年恢复最佳，各种术式均建议使用内固定。

Objective To explore the clinical features, treatment options and ways to reduce or avoid complications of ossification of thoracic ligamentum flavum （OTLF）. Methods Clinical features, imaging characteristics and types of OTLF were analyzed and therapeutic effects were observed through retrospective analysis of clinical data and surgical treatment of 54 patients with the disease. Results All cases in the group were followed up for more than 17 months after operation. JOA improvement rate was 〈 50% at 6 months after operation and 〈 70% at 1 year after operation respective- ly. Therapeutic effects of all cases were excellent or good at 2 years after operation. Conclusions Surgery should be ad- vised once OTLF is diagnosed. Surgical methods should be chosen based on clinical characteristics and imaging features. OTLF patients get the quickest recovery within 6 months and the best treatment effect within 2 years after operation. Inter-nal fixation is recommended in all surgical procedures.