胸椎黄韧带骨化症伴发其他原因压迫的外科治疗现状

Current surgical treatment of thoracic ossification of the ligamentum flavum with other causes of compression

黄韧带骨化诊治是脊柱外科的难题之一,对该疾病的发生机制及手术方案没有统一的标准。胸椎黄韧带骨化伴发硬脊膜骨化、后纵韧带骨化、后凸畸形等其他原因压迫的外科治疗难度更大,并且常伴有脑脊液漏等并发症。针对该类疾病的治疗方法,目前主要以后路减压为主,同时还要考虑不同压迫的特征进行手术设计,并妥善处理并发症。随着手术技巧的不断积累及治疗理念的发展,TOLF合并其他原因压迫的诊治会取得更令人满意的结果。

Diagnosis and treatment of ligamentum flavum ossification is one of the hard problems of spinal surgery. There is no uniform standard of the operation and mechanism of the occurrence of this disease. Surgical treatment of thoracic ligamentum flavum ossification with dural ossification,ossification of the posterior longitudinal ligament,thoracic kyphosis and other causes of compression are more difficult,and are often accompanied by cerebrospinal fluid leakage and other complications. At present, for the treatment of the disease, the posterior decompression is the main approach. Besides,we should also design different operations for the consideration of the characteristics of the different compression. Meanwhile,the complications of these operations should be properly handled. With the development of the steady accumulation of surgical techniques and the development of treatment concept,the diagnosis and treatment of TOLF with other causes of compression will lead to more satisfactory results.