The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Changchun University of Chinese Medicine, Changchun, 130117, China.
Acta Neurochir (Wien). 2023 Aug;165(8):2131-2137. doi: 10.1007/s00701-023-05603-9. Epub 2023 May 11.
Previous studies have demonstrated satisfactory outcomes of percutaneous endoscopic thoracic decompression (PETD) for single-segment thoracic ossification of the ligamentum flavum (TOLF). However, the clinical outcomes of PETD in patients with multi-segment TOLF (mTOLF) remain unclear. The aim of the present study was to evaluate the efficacy and safety of PETD for patients with multi-segment mTOLF.
Eighteen consecutive patients (41 segments) with mTOLF were treated with PETD between January 2020 and December 2021. The clinical outcomes were evaluated using the modified Japanese Orthopaedic Association (mJOA) score and Visual Analog Scale (VAS), whereas radiographic parameters were measured by cross-section area of the spinal canal and anteroposterior diameter of the spinal cord.
The follow-up period ranged from 14 to 34 months. The mean operation time and blood loss were 154.06 ± 32.14 min and 61.72 ± 12.72 ml, respectively. Hospital stay after first-stage operation was 10.89 ± 2.42 days. The mJOA score and VAS score significantly improved at the final follow-up, with a mean mJOA recovery rate of 63.3 ± 21.90%. The incidence of complications was 12.2% per level. The radiographic outcomes showed adequate decompression of the spinal cord.
The present study demonstrates that PETD is effective and safe as a minimally invasive procedure to treat patients with mTOLF. All patients showed relief of their symptoms and improvement in neurological function.
先前的研究表明，经皮内镜胸椎减压术（PETD）治疗单节段胸椎黄韧带骨化（TOLF）的效果令人满意。然而，多节段 TOLF（mTOLF）患者行 PETD 的临床效果尚不清楚。本研究旨在评估 PETD 治疗多节段 mTOLF 患者的疗效和安全性。
2020 年 1 月至 2021 年 12 月，18 例 mTOLF 患者（41 个节段）接受了 PETD 治疗。采用改良日本矫形协会（mJOA）评分和视觉模拟评分（VAS）评估临床疗效，通过椎管横截面积和脊髓前后径测量影像学参数。
随访时间为 14 至 34 个月。手术时间和出血量的平均值分别为 154.06 ± 32.14 分钟和 61.72 ± 12.72 毫升，一期手术后住院时间为 10.89 ± 2.42 天。末次随访时，mJOA 评分和 VAS 评分均显著改善，mJOA 恢复率平均为 63.3 ± 21.90%。并发症发生率为每节段 12.2%。影像学结果显示脊髓减压充分。
本研究表明，作为一种微创治疗方法，PETD 治疗 mTOLF 安全有效。所有患者的症状均得到缓解，神经功能得到改善。
