[1]蒋劲松,梁慕华,周树权,等. 经皮微通道单侧入路双侧显微减压术治疗局灶性胸椎黄韧带骨化症的疗效[J].中国医学物理学杂志,2019,36(5):610-613.[doi:DOI:10.3969/j.issn.1005-202X.2019.05.023]
　JIANG Jinsong,LIANG Muhua,ZHOU Shuquan,et al. Therapeutic effects of microsurgical decompression through paraspinal approach using percutaneous tubular retractor system on the isolated thoracic ossification of ligamentum flavum[J].Chinese Journal of Medical Physics,2019,36(5):610-613.[doi:DOI:10.3969/j.issn.1005-202X.2019.05.023]
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 经皮微通道单侧入路双侧显微减压术治疗局灶性胸椎黄韧带骨化症的疗效()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第5期
页码:
610-613
栏目:
医学生物物理
出版日期:
2019-05-25

文章信息/Info

Title:
 Therapeutic effects of microsurgical decompression through paraspinal approach using percutaneous tubular retractor system on the isolated thoracic ossification of ligamentum flavum
文章编号:
1005-202X（2019）05-0610-04
作者:
 蒋劲松; 梁慕华; 周树权; 覃开兵
 广西医科大学第七附属医院， 广西 梧州 543001
Author(s):
 JIANG Jinsong;  LIANG Muhua;  ZHOU Shuquan;  QIN Kaibin
 The Seventh Affiliated Hospital of Guangxi Medical University, Wuzhou 543001, China
关键词:
 ; 经皮微通道单侧入路双侧显微减压术; 局灶性胸椎黄韧带骨化症; 独立危险因素
Keywords:
 ; Keywords: microsurgical decompression through paraspinal approach using percutaneous tubular retractor system;  isolated thoracic ossification of ligamentum flavum;  independent risk factor
分类号:
R686.5
DOI:
DOI:10.3969/j.issn.1005-202X.2019.05.023
文献标志码:
A
摘要:
 目的：观察经皮微通道单侧入路双侧显微减压术治疗局灶性胸椎黄韧带骨化症（OLF）的疗效。方法：收集120例行经皮微通道单侧入路双侧显微减压术治疗局灶性OLF患者资料，对其进行回顾性分析，详细记录手术时间、住院时间、术中出血量及总体疗效，观察手术前后日本骨科学会（JOA）评分、疼痛视觉模拟（VAS）评分、肌酸磷酸激酶（CK-MM）活性，并按照疗效差异分为疗效可差组与优良组，比较两组临床资料，分析疗效影响因素。结果：手术时间（94.36±10.25） min，术中出血（38.12±4.63） mL，住院时间（7.68±0.82） d；术后6个月JOA评分明显高于术前（P<0.05），且VAS评分明显低于术前（P<0.05）；患者术前与术后第5天CK-MM活性比较无显著差异（P>0.05）；优良组病程显著短于可差组（P<0.05），平均年龄显著小于可差组（P<0.05），手术节段为中上胸椎所占比例、椎管面积残余率显著高于可差组（P<0.05）；高龄、病程长、手术节段累及胸腰段、椎管面积残余率低均为影响疗效的独立危险因素（P<0.05）。结论：经皮微通道单侧入路双侧显微减压术治疗局灶性OLF整体疗效显著，高龄、病程长、手术节段累及胸腰段、椎管面积残余率低为其独立危险因素。
Abstract:
Abstract: Objective To investigate the efficacy of microsurgical decompression through paraspinal approach using percutaneous tubular retractor system on the isolated thoracic ossification of ligamentum flavum (OLF). Methods The clinical data of 120 cases of microsurgical decompression through paraspinal approach using percutaneous tubular retractor system for the isolated thoracic OLF were retrospectively analyzed. The operation time, hospital stay, intraoperative blood loss and overall efficacy were recorded. Moreover, Japanese orthopaedic association score, pain visual analogue score and creatine phosphokinase activity before and after surgery were analyzed. According to the efficacy, the patients were divided into poor efficacy group and excellent efficacy group. The clinical data of the two groups were compared, so as to analyze the factors that might affect the therapeutic effects. Results The operation time, intraoperative blood loss and hospital stay were (94.36±10.25) min, (38.12±4.63) mL and (7.68±0.82) d, respectively. Japanese orthopaedic association score at 6 months after surgery was significantly higher than that before surgery (P<0.05), while pain visual analogue score was significantly lower than that before surgery (P<0.05). There was no significant difference in creatine phosphokinase activity before surgery and 5 days after surgery (P>0.05). The course of disease in excellent efficacy group was significantly shorter than that in poor efficacy group (P<0.05), and the mean age was significantly lower than that in poor efficacy group (P<0.05). Moreover, the proportion of the upper and middle thoracic vertebrae in the surgical segment and the residual rate of spinal canal area were significantly higher in excellent efficacy group than in poor efficacy group (P<0.05). The advanced age, long course of disease, thoracolumbar segment of the surgical segment and the low residual rate of the spinal canal area were the independent risk factors affecting therapeutic effects (P<0.05). Conclusion The microsurgical decompression through paraspinal approach using percutaneous tubular retractor system has a significant therapeutic effect on the isolated thoracic OLF. The advanced age, long course of disease, thoracolumbar segment of the surgical segment and the low residual rate of the spinal canal area are considered as the independent risk factors.

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备注/Memo

备注/Memo:
 【收稿日期】2018-11-26
【作者简介】蒋劲松，副主任医师，副教授，研究方向：脊柱、关节微创治疗，E-mail: mrjjs@163.com
更新日期/Last Update: 2019-05-23