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治疗黄韧带骨化合并硬脊膜骨化的新策略。

Novel therapeutic strategy in the treatment of ossification of the ligamentum flavum associated with dural ossification.

机构信息

Henan University, Henan Province, KaiFeng, China.

Zhoukou Central Hospital, Henan Province, Zhoukou, China.

出版信息

Eur Spine J. 2023 Mar;32(3):1068-1076. doi: 10.1007/s00586-023-07549-z. Epub 2023 Jan 30.

Abstract

PURPOSE

To investigate the imaging characteristics of thoracic ossification of ligamentum flavum (OLF) combined with dural ossification (DO) and the clinical efficacy of zoning laminectomy.

METHOD

The clinical data of 48 patients with thoracic OLF combined with DO who underwent zoning laminectomy between June 2016 and May 2020 were retrospectively analyzed. The modified Japanese Orthopedic Association (mJOA) score was used to evaluate neurological function before and after surgery, and the clinical efficacy was evaluated according to the improvement rate.

RESULTS

The symptoms of all patients significantly improved after the operation, and the average follow-up time was 27.8 (10-47) months. In addition, the average mJOA score had increased from 5.0 (2-8) preoperatively to 8.7 (6-11) postoperatively (t = 18.880, P < 0.05). The average improvement rate was 62.6% (25-100%), with 16 patients graded as excellent, 21 as good, and 11 as fair. Cerebrospinal fluid leakage occurred in 12 cases (25.0%), and all of them healed well after treatment. No postoperative aggravation of neurological dysfunction, wound infection or hematoma occurred. At the last follow-up, there was no recurrence of symptoms and kyphosis.

CONCLUSION

The Zoning laminectomy described here is both safe and effective.

摘要

目的

探讨胸段黄韧带骨化(OLF)合并硬脊膜骨化(DO)的影像学特征及分区椎板切除术的临床疗效。

方法

回顾性分析 2016 年 6 月至 2020 年 5 月间 48 例胸段 OLF 合并 DO 患者行分区椎板切除术的临床资料。采用改良日本矫形协会(mJOA)评分评估手术前后神经功能,根据改善率评估临床疗效。

结果

所有患者术后症状均明显改善,平均随访时间为 27.8(10-47)个月。此外,mJOA 评分由术前的 5.0(2-8)分平均增加至术后的 8.7(6-11)分(t=18.880,P<0.05)。平均改善率为 62.6%(25-100%),其中优 16 例,良 21 例,可 11 例。12 例(25.0%)发生脑脊液漏,经治疗后均愈合良好。无术后神经功能障碍加重、伤口感染或血肿发生。末次随访时,无症状复发和后凸畸形。

结论

分区椎板切除术安全有效。

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