脊柱内镜技术在胸椎黄韧带骨化症手术治疗中的应用

Spinal endoscopic technique in the surgical treatment of thoracic ossification of the ligamentum flavum

胸椎黄韧带骨化症(TOLF)是胸椎黄韧带的纤维组织转化为骨性组织的病理性异位骨化疾病,常导致胸椎管狭窄和胸脊髓神经受压。TOLF患者出现脊髓神经压迫症状时,通常需手术治疗,传统开放手术创伤大、脊髓神经损伤风险较高。近年来,国内外学者尝试将显微内镜、经皮椎间孔镜和单侧双通道内镜等脊柱内镜技术用于TOLF的治疗,在实现脊髓神经充分减压的同时,能最大限度地保留正常骨质,对脊柱稳定性破坏较小,具有手术创伤小、出血少和术后恢复快等优点。由于胸椎解剖结构特殊,内镜手术治疗胸椎疾病应重点关注安全性,建议在经验丰富的中心开展,并严格控制手术适应证。

Thoracic ossification of the ligamentum flavum(TOLF)is a pathological heterotopic ossification disease in which the fibrous tissue of the ligamentum flavum of the thoracic spine converts into bony tissue,often leading to thoracic spinal stenosis and compression of the thoracic spinal cord nerve.When TOLF patients present with symptoms of spinal cord nerve compression,surgical treatment is usually required,and traditional open surgery is more invasive and carries a higher risk of spinal cord nerve injury.In recent years,domestic and foreign researchers have tried to apply spinal endoscopic techniques such as microendoscopy,percutaneous foraminoscopy,and unilateral biportal endoscopy for the treatment of TOLF,which can maximize the preservation of normal bone while achieving adequate decompression of the spinal cord nerve,with less damage to spinal stability,and have the advantages of less surgical trauma,less bleeding,and faster postoperative recovery.Due to the special anatomical structure of the thoracic vertebra,spinal endoscopic techniques should focus on safety and it is recommended that they are performed in experienced centers,and surgical indications should be strictly controlled.