胸椎黄韧带骨化症的诊断与治疗

目的总结胸椎黄韧带骨化症（TOLF）的临床特点，手术方法及疗效，提高治疗效果。方法回顾性分析37例经过手术治疗的胸椎黄韧带骨化症患者的临床资料，其中30例行后路半关节突全椎板切除减压术，7例行后路半关节突全椎板切除加前路经胸腔侧前方椎管减压椎间盘切除及植骨融合内固定术。结果37例患者全部获得随访，随访时间6～78个月，平均38个月，疗效参照Epstein标准，优21例、良10例、改善5例、差1例。优良率83．78％。结论胸椎黄韧带骨化症一旦确诊，尽快手术治疗是唯一选择，手术可获得满意的疗效，手术疗效与脊髓损伤程度和病程长短有关。

Diagnosis and treatment of thoracic ossification of the ligamentum flavum

Objective To summarize the clinical characteristics and surgical procedures as well as the therapeutic effect of thoracic ossification of the hgamentum flavum （TOLF） for the aim of recognizing this disease and improving therapeutic efficacy. Methods Thirty - seven of TOLF were ana- lyzed retrospectively. Thirty cases were subjected to posterior total laminectomy and half of inner articular process decompression, and the remaining 7 cases to disc resection and internal fixation plus bone graft by anterior approach via the lateral and anterior of thoracic vertebrae combined with full - laminectomy for canal decompression by posterior approach. Results All the 37 patients were followed - up for an average of 38 months （6 to 78 months）. According to Epsteing standard,the outcomes were excellent in 21 cases, good in 10 cases, fair in 5 cases and poor in 1 case. Conclusion Once OLF is diagnosed definitely, early decompression could be the only effective method. Operation effect was related to the degree of spinal cord injury and the disease course.