胸椎黄韧带骨化症的治疗方法选择

目的研究胸椎黄韧带骨化症（ｏｓｓｉｆｉｃａｔｉｏｎｏｆｌｉｇａｍｅｎｔｕｍｆｌａｖｕｍ，ＯＬＦ）诊断与手术治疗的特点。方法采用回顾性研究方法对手术治疗的胸椎ＯＬＦ的病例进行总结分析。结果总计７２例ＯＬＦ，其中局灶型１５例，连续型４１例，跳跃型１６例；３７．５％合并颈椎后纵韧带骨化症（ｏｓｓｉｆｉｃａｔｉｏｎｏｆｐｏｓｔｅｒｉｏｒｌｏｎｇｉｔｕｄｉｎａｌｌｉｇａｍｅｎｔ，ＯＰＬＬ），１９．４％合并胸椎ＯＰＬＬ，９．７％合并胸椎间盘突出，１．４％同时合并颈、胸、腰椎ＯＰＬＬ，９．７％合并腰椎间盘突出。结论上述特点是胸椎ＯＬＦ诊断及选择治疗方法时要特别考虑的因素。“揭盖式”椎管后壁切除减压是治疗本病安全、有效的手术方法。

The Choice of Treatment for Ossification of Ligamentum Flavum of the Thoracic Spine

ObjectiveTo study characteristics of diagnosis and surgical treatment of ossification of ligamentum flavum(OLF) in the thoracic spine. MethodsSeventytwo cases of OLF treated surgically from 1980 to 1997 were studied retrospectively. ResultsOLF was seen between two laminae in 15 cases, continuously between more than two laminae in 41 cases, or and at intervals in 16 cases. 37.5%of the cases were combined with ossification of posterior longitudinal ligament(OPLL) of the cervical spine, 19.4%with OPLL of the thoracic spine, 9.7%with the thoracic disc protrusion, and 1.4%with OPLL of the cervicothoraciclumbar spine, 9.7%with lumbar disc protrusion.ConclusionAll of the above mentioned conditions should be considered when a diagnosis and surgical choice were made. Removal of the posterior wall of the thoracic spinal cannal with the use of the technique of cap uncoveringis a safe,convenient and effective method for the surgical treatment of OLF.