棘突截骨椎管成形术治疗腰椎黄韧带骨化症

The Treatment of Ossification of Ligamentum Flavum at Lumbar Spine with Spinal Canaloplasty by Spinous Process Osteotomies

目的 :观察棘突截骨椎管成形术治疗腰椎黄韧带骨化症的临床疗效和影像学。方法 :单侧椎板显露后行棘突基底截骨、中央椎管潜式扩大治疗 13例腰椎黄韧带骨化症患者 ,术前和术后进行腰椎功能Oswestry问卷调查和椎管直径测量。结果 :本组术后随访 2～ 4年 ,腰腿痛较术前平均改善 76 %～ 74% ,术后腰椎CT显示椎管中矢径平均增加2 1.6 % (P <0 .0 5 ) ,椎管横径平均增加 18.5 % (P <0 .0 5 )。结论 :棘突截骨椎管成形术治疗腰椎黄韧带骨化症 ,具有操作简单、椎管中央和侧方减压充分、对腰椎后方张力带结构影响小等优点 。

Objective: To describe a technique that affords a wide decompression of lumbosacral nerves while minimizing damage to posterior structures in patients with ossification of ligamentum flavum at lumbar spine,and to analyze the outcomes clinically and radiologically.Methods:Spinal canaloplasty by spinous process osteotomies for lumbosacral nerves decompression was taken in 13 patients suffering from ossification of ligamentum flavum at lumbar spine,and the procedure were analyzed clinically and radiologically after surgery.Results:The improvement of lumbosacral nerve functions (Oswestry Disability Index)was 76% one year after surgery.In postoperative CT imaging ,the sagittal diameter of spinal canal was increased by 21.6%( P <0.05),and the transverse diameter was increased by 18.5%( P <0.05).Conclusion:Spinous process osteotomies and canaloplasty for patients suffering from ossification of ligamentum flavum at lumbar spine affords easy performing,excellent decompression,while minimizing destruction to the posterior structure.