Qian Hu, Wang Xiuqian, Lei Ting, Ao Jun, Qin Jianpu
Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Department of Orthopaedic Surgery, Panzhou People's Hospital, Panzhou, China.
Orthop Surg. 2025 Jan;17(1):269-277. doi: 10.1111/os.14273. Epub 2024 Oct 19.
Current surgical strategies for thoracic ossification of the ligamentum flavum (TOLF) are denounced by thoracic kyphosis, loss of spinal motion range, etc. A new surgical technique, laminoplasty and in-site regrafting (LPIR), was modified to address the problems. This study aimed to report the safety and feasibility of LPIR for TOLF treatment.
This retrospective study reported the outcome of eight consecutive patients (3 males and 5 females, mean age 52.87 years) with TOLF who underwent LPIR surgery from January 2019 to March 2024. Pre- and post-operative data including x-ray, computerized tomography (CT), magnetic resonance imaging (MRI), the modified Japanese Orthopedic Association score (mJOA), the visual analog scale (VAS), and complications were collected to evaluate the outcome.
All surgeries were performed successfully, significantly alleviating symptoms postoperatively. During an average follow-up period of 28.63 months, the VAS score reduced from 4.50 ± 1.00 pre-operatively to 1.63 ± 0.48 on the third post-operative day and further reduced to 0.50 ± 0.70 during the last follow-up. The mJOA score increased from 3.63 ± 0.70 pre-operatively to 6.13 ± 0.78 on the third postoperative day and further increased to 8.88 ± 1.27 during the last follow-up. No severe complications were observed.
LPIR exhibited significant safety and feasibility for treating TOLF, offering a novel strategy for managing this problem.
目前治疗胸段黄韧带骨化症（TOLF）的手术策略存在诸如胸椎后凸、脊柱活动度丧失等问题。一种新的手术技术，即椎板成形术原位再植术（LPIR）被改良以解决这些问题。本研究旨在报告LPIR治疗TOLF的安全性和可行性。
这项回顾性研究报告了2019年1月至2024年3月期间连续8例接受LPIR手术的TOLF患者（3例男性，5例女性，平均年龄52.87岁）的治疗结果。收集术前和术后的数据，包括X线、计算机断层扫描（CT）、磁共振成像（MRI）、改良日本骨科协会评分（mJOA）、视觉模拟量表（VAS）以及并发症情况，以评估治疗效果。
所有手术均成功完成，术后症状明显缓解。在平均28.63个月的随访期内，VAS评分从术前的4.50±1.00降至术后第3天的1.63±0.48，并在末次随访时进一步降至0.50±0.70。mJOA评分从术前的3.63±0.70升至术后第3天的6.13±0.78，并在末次随访时进一步升至8.88±1.27。未观察到严重并发症。
LPIR在治疗TOLF方面显示出显著的安全性和可行性，为解决这一问题提供了一种新策略。
