显微镜微通道单侧入路治疗孤立型胸椎黄韧带骨化症

Microscopic microchannel unilateral approach in the treatment of isolated ossification of ligamentum flavum of thoracic vertebrae

目的探讨显微镜微通道单侧入路治疗孤立型胸椎黄韧带骨化症的临床疗效。方法采用显微镜微通道单侧入路治疗6例胸椎黄韧带骨化症患者。记录手术时间、术中出血量及术后住院时间。比较手术前后肌酸磷酸激酶(CK)水平,采用疼痛VAS评分和JOA评分评价临床疗效。结果患者均获得随访,时间6~20(10.1±5.7)个月。手术时间70~108(86.4±11.7)min,术中出血量25~65(40.7±12.5)ml,术后住院时间5~7(5.4±0.7)d。CK水平:术后1 d较术前明显升高(P<0.05);术后3、5 d恢复正常,与术前比较差异均无统计学意义(P>0.05)。VAS评分和JOA评分:术后5 d及1、6个月均较术前明显改善(P<0.05);术后1、6个月均较术后5 d明显改善(P<0.05);术后1个月与术后6个月比较差异无统计学意义(P>0.05)。结论显微镜微通道单侧入路治疗孤立型胸椎黄韧带骨化症具有创伤小、出血量少、手术时间短、患者术后恢复快等优点。

Objective To investigate the clinical effect of microscopic microchannel unilateral approach in the treatment of isolated ossification of ligamentum flavum of thoracic vertebrae.Methods Microscopic microchannel unilateral approach was used to treat 6 patients with ossification of ligamentum flavum of thoracic vertebrae.The operation time,intraoperative blood loss and postoperative hospitalization time were recorded.The levels of creatine phosphokinase(CK)before and after operation was compared,and the clinical efficacy was evaluated by pain VAS and JOA score.Results All patients were followed up for 6~20(10.1±5.7)months.The operative time was 70~108(86.4±11.7)min,the intraoperative bleeding volume was 25~65(40.7±12.5)ml,and the postoperative hospital stay time was 5~7(5.4±0.7)d.The level of CK at postoperative 1 d was significantly increased than the preoperation,and returned to normal at 3,5 d after operation;while there were no significant differences,compared with that before operation(P>0.05).VAS and JOA score:they were obviously improved at postoperative 5 d,1,6 months,compared with those before operation(P<0.05);and the scores at 1,6 months after operation were significantly improved than that at 5 d after operation(P<0.05);there was no significant difference between 1 month and 6 months after operation(P>0.05).Conclusions Microscopic microchannel unilateral approach for the treatment of isolated ossification of ligamentum flavum of thoracic vertebrae has the advantages of less trauma,less bleeding,shorter operation time and faster recovery.