单纯黄韧带骨化性胸脊髓压迫症10例

The compression of thoracic spinal cord induced by isolated ossification of ligament flavum

目的：探讨单纯黄韧带骨化性胸脊髓压迫症的发病机制、诊断和治疗。方法：分析10例手术治疗黄韧带骨化性胸脊髓压迫症的病史特点、MRI影像特征及手术减压疗效。结果：10例患者均有胸背外伤史，多在1年以上出现神经学损伤症状，病灶位于下胸椎多节段。手术疗效优良者2例，尚好7例，差1例。结论：胸背屈曲损伤1年以上渐进性出现双下肢无力，应疑有此病，同时辅以胸椎MRI诊断，一旦确诊即应行手术减压。

Objective:To study the pathogenesis,diagnos is and treatment of the thoracic myelopathy induced by isolated ossification of the ligament flavum.Methods:The clinical features of 10 patients with thoracic myelopath y induced by isolated ossification of the ligament flavum and the characteristic changes of the thoracic spinal MRI were analyzed and the efficiency of operative decompression was evaluated.Results:Every patient had a typical history of back trauma,most of t he patients appeared to have neurological symptom 1 year after the accident,and the myelopathic lesions of all patients were identified in a serie of segments in the lower thoracic spinal cord.Operative decompression was done in all the patients,the results of operation were shown to be:2 good,7 fine,only 1 poor. Conclusions:Compression of spinal cord should be suspected,if a flexion injury occur in the thoracic spine with gra dually increase in weakness of the legs for more than 1 year.Operative decompres sion should be performed as soon as the diseases were identified through clinical presentation and thoracic spina l MRI.The operative efficiency is satisfactory.