摘要
目的观察经皮脊柱内镜治疗单节段胸椎黄韧带骨化症(ossification of ligamentum flavum,OLF)的效果。方法回顾性分析2012-01至2018-06福州市第二医院收治的40例单节段OLF患者的临床资料,按手术方法不同分为微创内镜组与开放手术组。开放手术组(25例)采用开放手术摘除骨化黄韧带组织,微创内镜组(15例)采用内镜下手术摘除骨化黄韧带组织。比较两组术前、术后次日、术后3个月、术后1年改良日本骨科协会(Japanese Orthopaedic Association,JOA)下肢运动功能评分;并比较两组手术时间、手术出血量、术后住院时间、术后下地行走时间和术后并发症。结果两组术后次日、术后3个月、术后1年JOA评分均较术前改善,差异有统计学意义(P<0.05);两组术后次日、术后3个月JOA评分对比,差异无统计学意义(P>0.05);微创内镜组患者术后1年JOA评分高于开放手术组,差异有统计学意义(P<0.05);微创内镜组手术时间、术后住院时间、下地行走时间均短于开放手术组,术中出血量少于开放手术组,术后并发症发生率低于开放手术组,差异均有统计学意义(P<0.05)。结论经皮脊柱内镜治疗胸椎OLF是可行的,可降低术中出血量、住院时间和术后并发症发生率,且远期疗效优异。
Objective To observe effects of percutaneous spinal endoscopy in treatment of single-segment ossification of ligamentum flavum(OLF)of the thoracic spine.Methods The clinical data of 40 patients with single-segment OLF admitted to Fuzhou second hospital from January 2012 to June 2018 were retrospectively analyzed.They were divided into minimally invasive endoscopic group and open surgery groups according to different surgical methods.The open surgery group(25 cases)used open surgery to remove the ossified ligamentum flavum,while the minimally invasive endoscopic group(15 cases)used the endoscope.Then,the lower limb motor function scores of the Japanese orthopaedic association score(JOA)before the surgery,the next day after the surgery,3 months after the surgery,and 1 year after the surgery,operation time,bleeding volume,postoperative hospitalization time,walking time and postoperative complications were compared between the two groups.Results Compared with those before the surgery,the JOA scores in the two groups were improved the next day after the surgery,3 months after the surgery,and 1 year after the surgery,and the differences were statistically significant(P<0.05).There was no significant difference in the JOA scores of the next day after the surgery and 3 months after the surgery between the two groups(P>0.05).The 1-year JOA score in the minimally invasive endoscopic group was higher than that in the open surgery group,and the difference was statistically significant(P<0.05).Further,there were statistical differences in the intraoperative blood loss,hospitalization time and postoperative complications between the two groups(P<0.05).Conclusions It is feasible to treat ossification of OLF of the thoracic spine with percutaneous spinal endoscopy.It can reduce the intraoperative blood loss,hospitalization time and postoperative complications,and has excellent long-term efficacy.
作者
王朝晖
崔为良
薛经来
颜剑文
林毓涵
廖忠
WANG Chaohui;CUI Weiliang;XUE Jinglai;YAN Jianwen;LIN Yuhan;LIAO Zhong(Spine Surgery,Fuzhou Second Hospital Affiliated to Xiamen University,Fuzhou 350007,China)
出处
《中华灾害救援医学》
2020年第4期195-197,204,共4页
Chinese Journal of Disaster Medicine
基金
2018福州市科技计划社会发展项目(2018-S-101-8)。
关键词
经皮脊柱内镜
微创
单节段
胸椎黄韧带骨化症
percutaneous spinal endoscopy
minimally invasive
single segment
ossification of thoracic ligamentum flavum
