Yuan Qiang, Zheng Shan, Tian Wei
Department of Spine Surgery, Beijing Jishuitan Hospital, the Fourth Clinical Medical College of Peking University, Beijing 100035, China.
Department of Spine Surgery, Beijing Jishuitan Hospital, the Fourth Clinical Medical College of Peking University, Beijing 100035, China. Email:
Chin Med J (Engl). 2014;127(11):2043-7.
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.
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.
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).
CAMISS is a safe and effective procedure for resection of the OLF in the thoracic spine.
黄韧带骨化（OLF）已被广泛认为是胸椎管狭窄症和胸段脊髓病的主要病因之一。减压是治疗OLF所致胸段脊髓病的唯一有效策略。本研究的目的是描述计算机辅助微创脊柱手术（CAMISS）治疗OLF所致胸段脊髓病患者后路减压的临床效果。
所有病例均在术中三维导航系统辅助下进行手术。使用高速钻进行脊髓减压；部分保留棘上韧带和棘突。采用改良日本骨科协会（JOA）评分系统和恢复率评估疗效。
14例患者的平均随访时间为3.9年。所有患者均有神经功能恢复，JOA评分从术前的平均6.1分提高到末次随访时的8.6分，平均恢复率为52.7%（优2例，良8例，可3例，无变化1例）。
CAMISS是一种安全有效的胸椎OLF切除术式。
