Kuh Sung Uk, Kim Young Soo, Cho Yong Eun, Jin Byung Ho, Kim Keun Su, Yoon Young Sul, Chin Dong Kyu
Yongdong Severance Hospital, Department of Neurosurgery, Yonsei University, Medical College, Seoul, Korea.
Eur Spine J. 2006 Apr;15(4):485-91. doi: 10.1007/s00586-005-0903-9. Epub 2005 May 18.
The thoracic ossification of ligamentum flavum (OLF) is a disease that produces spastic paraparesis, and there are various factors that may affect the surgical outcome of thoracic OLF patients. The authors of this study treated 19 of these thoracic OLF patients from 1998 to 2002, and retrospectively reviewed the patients' age, sex, symptom duration, involved disease level, preoperative clinical features, neurological findings, radiological findings, the other combined spinal diseases and the surgical outcomes. There were excellent or good surgical outcomes in 16 patients, but 3 patients did not improve after thoracic OLF surgery: this included 1 patient, whose motor function worsened after decompressive thoracic OLF surgery. The favorable contributing factors of surgical outcome in thoracic OLF are a short preoperative symptom duration, single-level lesion, and unilateral lesion type on CT axial scan. On the contrary, the poor prognostic factors are beak type lesion and intramedullary signal changes on T(2)-weighted sagittal MRI. The complete preoperative evaluation including radiologic findings will provide valuable aid in presuming the surgical outcome for the thoracic OLF patients.
胸椎黄韧带骨化（OLF）是一种可导致痉挛性截瘫的疾病，有多种因素可能影响胸椎OLF患者的手术效果。本研究的作者在1998年至2002年期间治疗了19例此类胸椎OLF患者，并回顾性分析了患者的年龄、性别、症状持续时间、受累疾病节段、术前临床特征、神经学检查结果、影像学检查结果、其他合并的脊柱疾病以及手术效果。16例患者手术效果为优或良，但3例患者在胸椎OLF手术后未改善：其中1例患者在减压性胸椎OLF手术后运动功能恶化。胸椎OLF手术效果的有利因素包括术前症状持续时间短、单节段病变以及CT轴位扫描显示的单侧病变类型。相反，预后不良的因素是喙型病变和T2加权矢状位MRI上的脊髓内信号改变。包括影像学检查结果在内的完整术前评估将为推测胸椎OLF患者的手术效果提供有价值的帮助。
