摘要
目的:评价单纯椎板减压治疗氟骨病胸椎管狭窄症的远期疗效及其与胸椎后凸角度改变间的关系。方法:回顾分析1993～1997年采用单纯椎板减压治疗的氟骨病胸椎管狭窄症患者的临床资料,选择获得长期随访的患者,使用JOA评分标准进行疗效评价;测量并统计手术前后各时期胸椎后凸Cobb角,分析其对手术疗效的影响。结果:本组随访5年以上者27例,JOA评分由术前的4.26±0.94分提高到末次随访时的6.33±0.88分,胸椎后凸Cobb角由术前的29.60°±2.50°逐渐增加到末次随访时的41.70±2.81°,单因子变异数分析(one-wayANOVA)显示术后2年开始胸椎后凸显著增大,而JOA评分逐步下降,4例合并后纵韧带骨化的患者因胸椎后凸明显加大,症状恶化行二次手术。结论:单纯椎板切除减压对于氟骨病胸椎管狭窄症患者的胸椎稳定性有显著影响,伴随胸椎后凸的增大远期手术效果呈下降趋势。
Objective：To evaluate the long-term clinical validity of laminectomy for the treatment of fluorosis thoracic stenosis and assess the relationship between the outcomes and the thoracic kyphosis.Method：From 1993 to 1997,a total of 56 cases admitted as fluorosis thoracic stenosis underwent laminectomy alone.Of these,27 cases （15 males,12 females） who had been successfully followed up for at least 5 years were involved in our series.The clinical outcomes evaluated by the Japanese orthopedic association （JOA） score and the degree of thoracic kyphosis determined by Cobb＇s angle were analyzed through one-way ANOVA by software package SPSS 13.0.Result：The JOA score increased from 4.26±0.94 to 6.33±0.88 and the Cobb＇s angle developed from 29.60°±2.50° to 41.70°±2.81° at 5 year follow-up,One-way ANOVA revealed that the clinical results gradually declined during long-term follow up accompanied by dramatic increase of thoracic kyphosis which began 1st year after the operation.MRI images of 4 cases who underwent salvage operation for deterioration of neural function showed that progressive compression due to increasing thoracic kyphosis from the ventral side of the spinal cord.Condusion：Laminectomy alone is a simple and effective modality for the treatment of fluorosis thoracic stenosis,but it can causes development of thoracic kyphosis which impacts the long-term outcomes.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第6期426-429,共4页
Chinese Journal of Spine and Spinal Cord
