黄韧带骨化症型胸椎管狭窄症的临床特点及手术治疗【临床医学专业论文设计】

《黄韧带骨化症型胸椎管狭窄症的临床特点及手术治疗【临床医学专业论文设计】》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、临床医学论文-黄韧带骨化症型胸椎管狭窄症的临床特点及手术治疗【摘要】［目的］探讨黄韧带骨化症型胸椎管狭窄症(OLF-TSS)的临床特点及手术治疗效果。［方法］1998年10月〜2007年2月采用整块半关节突全椎板切除术治疗38例OLF-TSS患者。其中男25例，女13例;年龄29〜71岁，平均48岁。病变位于T10〜L13个椎间盘水平31例(£81.6%)。平均病程10个月。5.3%合并胸椎间盘突出。［结果］38例患者全部获得随访1〜8年，平均3年6个月。4例术中发生硬脊膜损伤;3例术后发生脑脊液漏，均经以俯卧位为主的综合保守治疗后痊愈。按照王自立临床疗效评价标准，优25例

2、，良11例，无改变2例，优良率94.7%°未出现定位错误和神经功能恶化者。［结论］OLF・TSS临床表现复杂，常见症状包括下肢麻木无力、腰背痛、间歇性跛行、束带感和括约肌功能障碍。症状和体征结合X线、MRI及CT检查是确诊的有效手段。采用整块半关节突全椎板切除术进行胸椎管后壁减压是安全、有效的方法。减少失误和并发症的对策是确定责任节段和规范手术操作。【关键词】黄韧带骨化症；胸椎管狭窄症；外科治疗Abstract:［ObjectiveJToevaluatetheclinicalcharacteristicsandeffectofoperativetreatmentforthe

3、ossificationof1igamentumflavumthoracicspinalstenosis(OLF-TSS).［Methods］FromOctober1998toFebruary2007,38patientswith0LF・TSSweretreatedwithcnblochemi-articularprocesslaminectomy.Inthisgroup,25casesweremale,and13caseswerefemale・Theaverageagewas48years(range,29〜71years).Totally81.6%ofthelesion

4、wasbetweenT10〜LIintervertebraldiscspace.Theaveragehistorywas10months.Therewere5.3percentwithprotrusionofintervertebraldiscofthoraciospine.[Rcsults]Thirty-eighteaseswerefollowed・upfor1〜8years,withanaverageof3yearsand6months.Duralinjuryoccurredin4casesof38,3casesappearedpostoperativecerebros

5、pinalfluidleakage.Al1caseswerecuredconservativelymainlywithbedrestintheprostrateposition.AccordingtoWANG'sevaluation,25hadexcellentresults,11hadgoodrcsults,2hadnochangeandnonewaspoor,Theexcellenttogoodratewas94.7%inthisgroup.Therewerenopatientswiththewrongleve1.Nopatientneurologicalfunctio

6、nsweredeteriorated.[ConclusionJThechinicalfeaturesof0LF・TSSareverycomplex・Thecommonsymptomsofthediseaseareprogressiveonsetofnumbness,weakness,lowbackpain,intermittentclaudicationofthe1owerextremities,constrictionontrunkor1ower1imbsandsphincterdysfunction.Theclinicalpresentationandneurologi

7、calexaminationassociatedwithX-rayfilm,MRIandCTweretheimportantmeansofthediagnosisofthedisease.Removaloftheposteriorwal1ofthethoracicspinalcanalviathetechniqueofenblochemi・articularprocesslaminectomyissafeandeffectivetotreat0LF・TSS.Thestrategyfordiminishingfaul