胸椎黄韧带骨化症的临床特征及疗效影响因素分析

目的 探讨胸椎黄韧带骨化症(ossification of ligamentum flavum,OLF)的临床特征,评估影响术后疗效的影响因素.方法 对本科2001年6月至2010年6月住院治疗并获得随访的28例胸椎黄韧带骨化症患者进行回顾性分析,运用术前、术后神经功能评价标准选用改良JOA评分(11分法),疗效评价...

Clinical characteristics and analysis of factors related to outcome for ossification of ligamentum flavum of thoracic spine

Objective To investigate the clinical characteristics of thoracic ossification of ligamentum flavum(OLF),and to analyze the factors influencing postoperative efficacy of thoracic OLF.Methods A retrospective analysis was performed in 28 patients who underwent surgical treatments to thoracic OLF in the hospital and were successfully followed up from June 2001 to June 2010.Modified Japanese Orthopedic Association(JOA) scale(maximum total score of 11) was applied to evaluate the patients’ nerve functions pre-and postoperatively and recovery rate(RR) was applied to evaluate treatment efficacy.The influencing factors on OLF efficacy were analyzed using Pearson correlation and intra-group comparison using t-test.Results The most common initial symptoms were numbness(78.6%) and motor dysfunction(71.4%) in the lower extremities.The pre-and postoperative JOA scores were 4.5±2.2 and 8.5±2.6 respectively(P<0.05).The postoperative RR was(59.2±28.2) %,according to which the efficacy of the OLF patients were classified as 15 excellent(53.6%),7 good(25.0%),3 moderate(10.7%) and 3 bad(10.7%).The efficacy of thoracic OLF operation was related to the preoperative course,JOA score and intramedullary signal change,but not related to age,sex,location and the number of segmental lesion and whether complicated with other spinal diseases.Conclusion Preoperative course,JOA score and intramedullary signal change were important predictive factors for surgical outcome of thoracic OLF.Operations of decompression in early period could promote OLF patients’ symptoms alleviation and neurological recovery.