氟骨症性胸椎黄韧带骨化手术治疗

Surgical treatment of fluorosis thoracic ossified ligamentum flavum

目的 回顾分析了１８例氟骨症性胸椎黄韧带骨化的诊断和手术治疗特点。方法１９８８～１９９９年收治的１８例氟骨症性胸椎黄韧带骨化患者，叙述了临床表现，影像学检查结果（Ｘ光平片、脊髓造影、ＣＴ及ＭＲＩ），手术治疗。结果１８例均经手术治疗。手术节段３～７节，平均５．２节。随诊时间均超过１年，优良率占７３．３％。结论（１）氟骨症性胸椎黄韧带骨化手术治疗是有效的。（２）氟骨症性胸椎黄韧带骨化患者病情复杂，临床表现多样，术前定位依靠详细的物理检查和必要的特殊检查，如 ＭＲＩ、脊髓造影等。（３）手术为后路椎板切除＋关节突部分切除术，术前准备要充分，术中操作要轻柔。对多节段受累者采取分次手术或分段手术。

Objective: Eighteen Patients who had thoracic ossified ligamentum flavum were prospectively studied about the diagnosis and operation. Methods We studied eighteen patients who had thoracic ossified ligament turn flavum from 1988 to 1999. We studied their clinic, radiography which included plain radiographs, myelograms, CT and MRI, operation. Results Eighteen patients were all operated. The lavol of the operation was from three to seven thoracic spines. The mean is 5. 2. The patients were followed above one year. The rate of excellent result was 73.3 percent. Conclusion (l) The operation of the thoracic ossified ligamentum flavum is effective. (2)The states of the patients who had thoracic ossified ligamentum flavum are very complex. The clinical display are very mere. The preoperative location relied on careful physical examination and necessary special inspection, such as MRI and myelography. (3)The operative part is the posterior laminectomy and part dectomy of facet joints. The prepare should be enough. The operation should be fine.