Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF) combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic...Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF) combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic OLF combined with展开更多
Background Ossification of the ligamentum flavum （OLF） has been widely recognized as one of the main causes of thoracic spinal canal stenosis and thoracic myelopathy.Decompression is the only effective strategy for ...Background Ossification of the ligamentum flavum （OLF） has been widely recognized as one of the main causes of thoracic spinal canal stenosis and thoracic myelopathy.Decompression is the only effective strategy for treating thoracic myelopathy caused by OLF.The purpose of this study was to describe the clinical outcomes of computer-assisted minimally invasive spine surgery （CAMISS） for posterior decompression in patients with thoracic myelopathy caused by OLF.Methods In all cases,the surgical procedure was performed with the assistance of an intraoperative three-dimensional navigation system.Decompression of the spinal cord was performed with a high-speed drill; the supraspinal ligaments and spinous process were partially preserved.The outcomes were evaluated by a modified Japanese Orthopedic Association （JOA） scoring system and recovery rates.Results The mean duration of follow-up for the 14 cases was 3.9 years.All patients experienced neurological recovery,the mean JOA score improving from 6.1 points preoperatively to 8.6 points at final follow-up and the mean rate of recovery being 52.7% （excellent in two cases,good in eight,fair in three,and unchanged in one）.Conclusion CAMISS is a safe and effective procedure for resection of the OLF in the thoracic spine.展开更多
目的探讨后路减压内固定手术治疗胸椎黄韧带骨化症(ossification of ligamentum flavum,OLF)的临床疗效,并探讨其预后影响因素。方法自2013-09-2016-09,采用后路减压内固定手术治疗53例胸椎OLF患者,术后随访13-27个月。依据末次随访时的...目的探讨后路减压内固定手术治疗胸椎黄韧带骨化症(ossification of ligamentum flavum,OLF)的临床疗效,并探讨其预后影响因素。方法自2013-09-2016-09,采用后路减压内固定手术治疗53例胸椎OLF患者,术后随访13-27个月。依据末次随访时的JOA评分改善率,将之分为预后较好组(改善率≥25%)和预后不良组(<25%)。统计所有患者的相关资料,并进行手术预后的组间单因素分析和多因素Logistic回归分析。结果①53例术前JOA评分平均为(5.13±1.06)分,截止末次随访时,已恢复至平均(8.75±1.31)分。其中JOA改善率≥25%者共计42例,均预后较好(79.25%);改善率<25%者共计11例,均预后不良。②单因素分析显示,椎管面积残余率、T2加权像髓内高信号和大小便功能障碍这3项因素的数据,在预后较好组与预后不良组之间存在显著性差异(P<0.05);多因素Logistic回归分析证实,椎管面积残余率<80%、存在T2WI髓内高信号和大小便功能障碍这3项,均为预后不良的独立危险因素之一。结论采用后路减压内固定手术治疗胸椎OLF,可取得较好疗效。但术前椎管面积残余率<80%、存在T2WI髓内高信号和大小便功能障碍者,均是预后不良的危险因素。展开更多
文摘Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF) combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic OLF combined with
文摘Background Ossification of the ligamentum flavum （OLF） has been widely recognized as one of the main causes of thoracic spinal canal stenosis and thoracic myelopathy.Decompression is the only effective strategy for treating thoracic myelopathy caused by OLF.The purpose of this study was to describe the clinical outcomes of computer-assisted minimally invasive spine surgery （CAMISS） for posterior decompression in patients with thoracic myelopathy caused by OLF.Methods In all cases,the surgical procedure was performed with the assistance of an intraoperative three-dimensional navigation system.Decompression of the spinal cord was performed with a high-speed drill; the supraspinal ligaments and spinous process were partially preserved.The outcomes were evaluated by a modified Japanese Orthopedic Association （JOA） scoring system and recovery rates.Results The mean duration of follow-up for the 14 cases was 3.9 years.All patients experienced neurological recovery,the mean JOA score improving from 6.1 points preoperatively to 8.6 points at final follow-up and the mean rate of recovery being 52.7% （excellent in two cases,good in eight,fair in three,and unchanged in one）.Conclusion CAMISS is a safe and effective procedure for resection of the OLF in the thoracic spine.
文摘目的探讨后路减压内固定手术治疗胸椎黄韧带骨化症(ossification of ligamentum flavum,OLF)的临床疗效,并探讨其预后影响因素。方法自2013-09-2016-09,采用后路减压内固定手术治疗53例胸椎OLF患者,术后随访13-27个月。依据末次随访时的JOA评分改善率,将之分为预后较好组(改善率≥25%)和预后不良组(<25%)。统计所有患者的相关资料,并进行手术预后的组间单因素分析和多因素Logistic回归分析。结果①53例术前JOA评分平均为(5.13±1.06)分,截止末次随访时,已恢复至平均(8.75±1.31)分。其中JOA改善率≥25%者共计42例,均预后较好(79.25%);改善率<25%者共计11例,均预后不良。②单因素分析显示,椎管面积残余率、T2加权像髓内高信号和大小便功能障碍这3项因素的数据,在预后较好组与预后不良组之间存在显著性差异(P<0.05);多因素Logistic回归分析证实,椎管面积残余率<80%、存在T2WI髓内高信号和大小便功能障碍这3项,均为预后不良的独立危险因素之一。结论采用后路减压内固定手术治疗胸椎OLF,可取得较好疗效。但术前椎管面积残余率<80%、存在T2WI髓内高信号和大小便功能障碍者,均是预后不良的危险因素。
