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全内镜下治疗黄韧带骨化所致胸段脊髓病:病例系列

Full-endoscopic decompression for thoracic myelopathy caused by ossification of the ligamentum flavum: patient series.

作者信息

Kotheeranurak Vit, Pholprajug Phattareeya, Lin Guang-Xun, Pruttikul Pritsanai, Yingsakmongkol Wicharn, Tejapongvorachai Tawechai, Kim Jin-Sung

机构信息

Department of Orthopedics, Queen Savang Vadhana Memorial Hospital, Thai Red Cross Society, Sriracha, Chonburi, Thailand.

Department of Orthopedics, Rayong Hospital, Rayong, Thailand.

出版信息

J Neurosurg Case Lessons. 2021 Feb 8;1(6):CASE20138. doi: 10.3171/CASE20138.

Abstract

BACKGROUND

This study aimed to describe the least invasive surgical technique of endoscopic decompression for thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) and to review the literature available on the diagnosis and treatment of OLF.

OBSERVATIONS

The mean age of the patients was 51.2 (range, 40-62) years, and the mean preoperative, 2-week postoperative, and last follow-up modified Japanese Orthopaedic Association scores were 6.6 (range, 4-10), 9.6 (range, 7-11), and 13 (range, 10-14), respectively. All patients were discharged within 48 hours after the surgery. The mean follow-up period was 13.2 (range, 7-18) months. No complication was found perioperatively, and none of the patients had postoperative instability during the follow-up period.

LESSONS

Based on this clinical case series and literature review, the authors conclude that endoscopic decompression surgery is feasible and effective for managing thoracic myelopathy caused by OLF while minimizing surrounding tissue damage. Additionally, it enables shorter periods of hospital stay.

摘要

背景

本研究旨在描述针对黄韧带骨化(OLF)所致胸段脊髓病的内镜减压最微创外科技术,并综述有关OLF诊断和治疗的现有文献。

观察结果

患者的平均年龄为51.2岁(范围40 - 62岁),术前、术后2周及末次随访时改良日本骨科协会评分的平均值分别为6.6分(范围4 - 10分)、9.6分(范围7 - 11分)和13分(范围10 - 14分)。所有患者均在术后48小时内出院。平均随访期为13.2个月(范围7 - 18个月)。围手术期未发现并发症,随访期间无患者出现术后不稳定情况。

经验教训

基于该临床病例系列和文献综述,作者得出结论,内镜减压手术对于治疗OLF所致胸段脊髓病是可行且有效的,同时能将周围组织损伤降至最低。此外,它还能缩短住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a8/9394180/d86135f86ffe/CASE20138f1.jpg

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