Fujimura Y, Nishi Y, Nakamura M, Toyama Y, Suzuki N
Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.
Spine (Phila Pa 1976). 1997 Feb 1;22(3):305-11. doi: 10.1097/00007632-199702010-00015.
This was a retrospective study of the results of anterior decompression and fusion in patients with thoracic myelopathy secondary to ossification of the posterior longitudinal ligament with a minimum follow-up time of 5 years.
To clarify the effectiveness and limits of anterior decompression and fusion for thoracic ossification of the posterior longitudinal ligament.
Posterior decompression for the surgical management of thoracic ossification of the posterior longitudinal ligament has had an uncertain success record. Anterior decompression and fusion have been considered the treatment of choice however, there are few reports describing the long-term results.
The participants in this investigation were 33 patients whose cases were followed for an average period of 8 years and 2 months. The factors that were investigated included changes in the Japanese Orthopedic Association score and in recovery rates, postoperative complications, and radiographic findings of bone union and progression of ossification of the posterior longitudinal ligament within the area of anterior decompression.
Although the recovery rates were relatively stable from 1-5 years after surgery, the rates declined thereafter. The average recovery rate at the final follow-up visit was 53.2%. Postoperative complications included three cases of deterioration of thoracic myelopathy and four cases of extrapleural cerebrospinal fluid leakage. Except for the one case of deterioration of thoracic myelopathy, the remainder of the complications were transient.
Anterior decompression and fusion is an effective surgical procedure for thoracic ossification of the posterior longitudinal ligament with good, stable, long-term results; when thoracic ossification of the posterior longitudinal ligament was extensive or coincident with ossification of the intraspinal ligament, however, the results were not as predictable.
这是一项对因后纵韧带骨化继发胸段脊髓病患者进行前路减压融合术结果的回顾性研究，最短随访时间为5年。
阐明后纵韧带胸段骨化前路减压融合术的有效性和局限性。
后纵韧带胸段骨化手术治疗的后路减压成功率尚无定论。然而，前路减压融合术一直被视为首选治疗方法，但描述长期结果的报告较少。
本研究的参与者为33例患者，其病例平均随访8年零2个月。研究的因素包括日本骨科协会评分和恢复率的变化、术后并发症以及前路减压区域内骨愈合和后纵韧带骨化进展的影像学表现。
尽管术后1至5年恢复率相对稳定，但此后恢复率下降。末次随访时的平均恢复率为53.2%。术后并发症包括3例胸段脊髓病恶化和4例胸膜外脑脊液漏。除1例胸段脊髓病恶化外，其余并发症均为一过性。
前路减压融合术是治疗后纵韧带胸段骨化的有效手术方法，长期效果良好且稳定；然而，当后纵韧带胸段骨化范围广泛或与脊髓内韧带骨化同时存在时，结果则难以预测。
