全椎板切除减压治疗胸椎黄韧带骨化症的短期疗效分析Short term effect of total laminectomy for the treatment of ossification of the thoracic ligamentum flavum.pdfVIP

提 要 目的：评价全椎板切除减压治疗胸椎黄韧带骨化症(thoracic ossification of ligament flavum TOLF) 的短期疗效，并对随访结果进行分析，为临床提供参考。 方法：采用电话或门诊预约等形式，对山东中医药大学附属医院脊柱骨科 2008 年 6 月至 2011 年 2 月有完整临床资料及随访资料，并进行手术治疗的 20 例胸椎黄韧 带骨化症患者进行随访。采用 JOA 下腰痛评分和 JOA 改善率对患者术前和末次随访 进行评定。应用独立样本 t 检验，对年龄、性别、病程、影像学分型、椎管残余面积 与 JOA 改善率之间的关系进行统计学分析，探讨上述因素对术后疗效的影响。 结果：术前脊髓 JOA 评分平均(5.65±1.27)分，术后脊髓 JOA 评分平均为(8.30 ±2.68)分，JOA 改善率平均为（53.16±36.30）%，末次随访时患者JOA 评分较前 有明显改善，差别具有统计学意义（P0.05 ）。JOA 评分改善率评定：优 5 例，良 10 例，可 3 例,差 2 例，优良率 75% 。胸椎黄韧带骨化型胸椎管狭窄的手术疗效与病程、 术前 JOA 评分、椎管残余面积、MRI 信号改变等有关，与年龄、性别无关。 结论：术前胸髓 MRI 信号改变、椎管残余面积率、病程是影响胸椎黄韧带骨化 症手术疗效的因素，术前合理选择手术时机和方式，可减少不利因素的影响，提高术 后疗效，并对手术疗效进行预测。 关键词 胸椎 椎板切除减压 黄韧带骨化 疗效 The Efficacy analysis Posterior omni-posterior decompression resection for thoracic ossification of ligament flavum Speciality: Orthopedics of TCM Author: Xue Haipeng Tutor: Prof. Xu Zhanwang Abstract Objective:To evaluate the short-term effects of posterior laminectomy for the ossification of ligamentum flavum (OLF),and Analysis results of follow-up,then the results were analyzed for clinical reference. Methord:By telephone or out-patient appointments and other forms,from June 2008 to February 2011 with posterior laminectomy treatment in in Affiliated Hospital of Shandong University of TCM orthopedics spine department. 20 cases,who met the inclusion criteria,had full clinical and follow-up data,were followed up.according to JOA Low Back Pain score and JOA scroe improved rate to assess the preoperative and final follow-up information We use independent samples T test for age, disease course,MRI T2,Canal area residual ratio and symmetry with the JOA score improved rate for statistical analysis. Results: