椎板切除手术治疗胸椎黄韧带骨化并椎管狭窄的论文.docVIP

　　椎板切除手术治疗胸椎黄韧带骨化并椎管狭窄的论文 【摘要】 目的 探讨整块全椎板切除或椎板分解切除手术治疗胸椎黄韧带骨化合并胸椎管狭窄的效果。方法 分析2007年12月至2010年12月间随访资料完整16例胸椎黄韧带骨化合并胸椎管狭窄的患者。其中男性11例，女性5例，年龄38-75岁，平均56.5岁，其中上胸段1人，中胸段3人，下胸段12人，病程2月-3年。通过ct或mri检查均提示黄韧带骨化，且脊髓受压。手术均采用全椎板切除或椎板分解切除并行脊柱后外侧融合、钉棒系统固定。术后疗效采用日本骨科协会（japanese orthopaedic association）评分（joa评分）标准进行评价。结果 16例患者均随访3-24个月，平均20个月。joa评分由术前3-13分提高到术后13-29分，手术前后有明显统计学差异（p＜0.01），术后神经恢复率20%-82%，平均65%，16例患者8例优，5例良，2例中，1例差，优良率81.3%。结论 全椎板整块切除或分解切除后外侧脊柱椎体融合治疗胸椎黄韧带骨化合并椎管狭窄疗效肯定。 【关键词】 胸椎黄韧带骨化 椎管狭窄 椎板切除 手术效果 【abstract】 objective: to study the entire block omni-posterior excision or lamina deposition for thoracic yelloent surgery thoracic spinal stenosis ossification merge the effect. methods: analysis of december 2007 betber 2010 folloent thoracic spinal stenosis ossification merger of patients. 11 cases of men and en in 5 patients, and the age of 38 - age 75, average age five, including the thoracic segments on thoracic segments, 1 in 3 thoracic segments under 12 people, course 2 months - 3 years. through strongly suggest that examined by ct or mri, and yelloent ossification discitis. surgery adopts omni-posterior excision or lamina deposition resection of posterolateral spinal fusion, parallel nail rod fixation. postoperative curative effect using japanese orthopaedic association (japanese orthopaedic association) score (joa score) standard evaluation. results: all patients are folloonths, an average of 20 months. by joa scores improve preoperative 3-13 points on postoperative 13-29 points, surgery and has significant difference (p lt; 0.01), postoperative neurological recovery rate 20% - 82%, average 65%, 16 patients 8 cases of optimal, 5 cases ni-posterior block excision or deposition of posterolateral spinal resection interbody fusion treat thoracic spinal stenosis yelloent ossification merger assured curative effects 【key ent lamina resection operation effect 胸椎黄韧带骨化（olf）是导致胸椎管狭窄的主要原因。.cOm采用揭盖式椎管后壁切除减压治疗olf安全性和有效性已经得到普遍认同和应用。广泛的胸椎切除后，固定融合可避免胸背部后凸加重，并可能通过减小局部的张应力而防止o