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老年人钙化性胸椎间盘突出症:重新审视单节段疾病的椎板切除术

Calcified Thoracic Disc Herniations in the Elderly: Revisiting the Laminectomy for Single Level Disease.

作者信息

Oitment Colby, Kwok Desmond, Steyn Chris

机构信息

McMaster University, Hamilton, Ontario, Canada.

出版信息

Global Spine J. 2019 Aug;9(5):527-531. doi: 10.1177/2192568218806274. Epub 2018 Nov 5.

Abstract

STUDY DESIGN

Retrospective case series.

OBJECTIVES

Calcified thoracic disc herniations in the elderly present with a variety of clinical conditions and the treatment is a source of significant debate. Decompression of the disc space is done through anterior, lateral, posterolateral, and posterior approaches. There is significant morbidity of thoracic disc herniation and associated decompression.

METHODS

The present report is a case series of 8 elderly patients with calcified discopathy who received a simple laminectomy without decompression of the disc space.

RESULTS

Postoperatively, 5 patients mobilized independently, 2 with a walker, and 1 patient was nonambulatory. Two patients improved 1 ASIA (American Spinal Injury Association Impairment Scale) score, 1 patient improved 2 ASIA scores, and 3 patients had no change in ASIA score.

CONCLUSION

In our experience, thoracic disc herniations require a technically difficult decompression and overall the complications are significant. We present a series of 8 patients who generally improved from a simple laminectomy and consider this a viable procedure for patients too unwell to undergo direct disc decompression.

摘要

研究设计

回顾性病例系列。

目的

老年患者的钙化性胸椎间盘突出症临床表现多样,其治疗存在重大争议。椎间盘间隙减压可通过前路、外侧、后外侧和后路进行。胸椎间盘突出症及相关减压手术有显著的发病率。

方法

本报告是一组8例患有钙化性椎间盘病的老年患者的病例系列,这些患者接受了单纯椎板切除术,未进行椎间盘间隙减压。

结果

术后,5例患者可独立活动,2例需借助助行器,1例不能行走。2例患者美国脊髓损伤协会(ASIA)损伤量表评分提高1分,1例患者提高2分,3例患者ASIA评分无变化。

结论

根据我们的经验,胸椎间盘突出症需要技术难度大的减压手术,总体并发症较多。我们报告了一组8例患者,他们通过单纯椎板切除术总体病情有所改善,我们认为对于身体状况太差而无法接受直接椎间盘减压的患者,这是一种可行的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79e7/6686386/a6c56095b38e/10.1177_2192568218806274-fig1.jpg

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