Department of Endoscopic Diagnosis, Daqing Oilfield General Hospital, Daqing, Heilongjiang, China; Department of Orthopaedic, Chengde Medical University Affiliated Hospital, Chengde, Hebei, China.
Department of Orthopaedic, Daqing Oilfield General Hospital, Daqing, Heilongjiang, China.
World Neurosurg. 2023 Feb;170:e666-e672. doi: 10.1016/j.wneu.2022.11.093. Epub 2022 Nov 28.
This study aimed to investigate the short-term efficacy of percutaneous endoscopic thoracic decompression (PETD) under local anesthesia and traditional posterior thoracic laminectomy (PTL) in treating single-segment thoracic ossification of the ligamentum flavum (T-OLF).
This was a retrospective review of the clinical information of 52 patients with T-OLF between September 2017 and September 2021. Based on the inclusion criteria, a total of 52 patients were included in the present research, 26 in the PETD group and 26 in the PTL group. The general preoperative data, intraoperative surgical conditions, preoperative and postoperative clinical information, and complications were collected. The modified Japanese Orthopedic Association score and recovery rate were evaluated preoperatively and at 3, 6, and 12 months postoperatively.
There was no statistically significant difference in the baseline parameters in either group (P > 0.05). There were statistically significant differences in operation time (94.62 vs. 144.62 minute) and blood loss (22.12 vs. 287.69 mL) between the PETD group and the PTL group. The modified Japanese Orthopedic Association score in the 2 groups improved from (5.46 ± 1.10) and (5.69 ± 1.01) preoperatively to (9.08 ± 0.90) and (8.88 ± 1.07) at 12 months postoperatively. The recovery rate was 84.6% in the PETD group and 76.9% in the PTL group. In addition, the complications in the PETD group were fewer than those in the PTL group.
The PETD under local anesthesia for T-OLF has many advantages, such as high patient acceptance, good short-term clinical outcomes, and few complications; therefore, this procedure should be promoted as a viable treatment option for T-OLF.
本研究旨在探讨局部麻醉下经皮内镜胸椎减压术（PETD）与传统后路胸椎椎板切除术（PTL）治疗单节段胸椎黄韧带骨化（T-OLF）的短期疗效。
这是一项回顾性研究，纳入了 2017 年 9 月至 2021 年 9 月期间的 52 例 T-OLF 患者的临床资料。根据纳入标准，共有 52 例患者纳入本研究，其中 PETD 组 26 例，PTL 组 26 例。收集两组患者的一般术前资料、术中手术情况、术前和术后临床资料以及并发症。采用改良日本矫形协会评分（mJOA）评估术前及术后 3、6、12 个月的疗效。
两组患者的基线参数差异均无统计学意义（P > 0.05）。PETD 组手术时间（94.62 分钟比 144.62 分钟）和术中出血量（22.12 毫升比 287.69 毫升）明显少于 PTL 组。两组患者 mJOA 评分均较术前（5.46 ± 1.10 分比 5.69 ± 1.01 分）明显改善，至术后 12 个月（9.08 ± 0.90 分比 8.88 ± 1.07 分）。PETD 组的恢复率为 84.6%，PTL 组为 76.9%。此外，PETD 组的并发症少于 PTL 组。
局部麻醉下经皮内镜胸椎减压术治疗 T-OLF 具有患者接受度高、短期临床疗效好、并发症少等优点，应作为 T-OLF 的一种可行治疗选择。
