经皮脊柱内镜微创技术治疗胸椎黄韧带骨化症

Percutaneous endoscopic decompression for thoracic myelopathy secondary to ossification of the ligamentum flavum

[目的]介绍经皮内镜技术对胸椎黄韧带骨化导致脊髓病变进行彻底减压治疗经验。[方法]运用经皮脊柱内镜技术通过椎板间入路对2例胸椎黄韧带骨化导致脊髓压迫的患者进行手术减压。精确定位后,建立工作通道,磨除关节突,显露骨化的黄韧带,再将骨化物磨薄,切除。[结果]患者术前神经症状在术后均明显改善,术后复查胸椎CT显示减压效果良好。[结论]经皮内镜技术治疗胸椎黄韧带骨化导致的脊髓病变可在镜下进行直接减压,同时尽量减少创伤和术后不稳,为治疗黄韧带骨化提供一种新的选择。

[Objective] To introduce the surgical technique of percutaneous endoscopic complete decompressions for thoracic myelopathy secondary to thoracic ossification of the ligamentum flavum(OLF).[Methods] Two patients underwent percutaneous endoscopic complete decompression through interlaminar approach for thoracic myelopathy secondary to OLF. After accurate location, the work passage was created, the facet processes were removed by burring to expose the ossified ligamentum flavum. After that, the ossified block was gradually thinned by burring, and completely took away with a rongeur.[Results] After surgery, the 2 patients experienced significant improvement in the neurological symptoms. Postoperative thoracic computed tomography showed the ossification of ligaments was removed completely.[Conclusion] This percutaneous endoscopic decompression, with advantages of direct remove of the ossified ligaments, minimizing iatrogenic trauma, diminishing the interference to spinal stability, is a new choice for surgical treatment of thoracic myelopathy secondary to ossification of the ligamentum flavum.