本文選題：椎板減壓 + 內(nèi)固定�。� 參考：《中國矯形外科雜志》2017年13期

【摘要】：[目的]研究胸椎黃韌帶骨化癥(ossification of ligamentum flavum,OLF)采用后路椎板減壓內(nèi)固定術(shù)治療的療效及預(yù)后影響因素。[方法]對2012年1月~2015年10月經(jīng)手術(shù)治療且完整隨訪的51例胸椎OLF患者資料進(jìn)行回顧性分析,對可能影響患者預(yù)后的因素,如性別、年齡、病程、術(shù)前及術(shù)后日本骨科協(xié)會(JOA)評分、椎管面積殘余率、T2加權(quán)像髓內(nèi)高信號、術(shù)前是否存在二便功能障礙、術(shù)后是否存在腦脊液漏等因素進(jìn)行χ2檢驗和Logistic回歸統(tǒng)計分析。[結(jié)果]根據(jù)術(shù)后JOA評分改善率分為優(yōu)良組(JOA改善率≥25%,38例)和不良組(JOA改善率25%,13例),術(shù)后恢復(fù)優(yōu)良率74.51%。兩組間年齡、術(shù)前JOA評分及病程等患者一般資料差異無統(tǒng)計學(xué)意義(P0.05),在T2加權(quán)像髓內(nèi)高信號(P=0.004)、椎管面積殘余率(P=0.009)及術(shù)前存在二便功能障礙(P=0.002)等方面差異具有統(tǒng)計學(xué)意義;Logistic回歸分析發(fā)現(xiàn)病變T2加權(quán)像髓內(nèi)高信號(OR=6.202)、椎管面積殘余率(OR=13.286)及術(shù)前存在二便功能障礙(OR=25.905)與預(yù)后影響關(guān)系密切。[結(jié)論]后路椎板減壓內(nèi)固定手術(shù)治療胸椎OLF效果良好,患者術(shù)前存在T2加權(quán)像髓內(nèi)高信號、椎管面積殘余率≤80%、二便功能障礙提示預(yù)后不良。
[Abstract]:[objective] to study the curative effect and prognostic factors of ossification of ligamentum flavum ossification of thoracic vertebrae treated by posterior laminectomy and internal fixation. [methods] the data of 51 patients with OLF of thoracic vertebra from January 2012 to October 2015 were analyzed retrospectively. The prognostic factors, such as sex, age, course of disease, were analyzed retrospectively. Preoperative and postoperative Japanese orthopedic association (JOAA) score, spinal canal area residual rate (T2-weighted) and intramedullary hyperintensity (T2-weighted) were analyzed by 蠂 2 test and Logistic regression. [results] according to the improvement rate of JOA score after operation, the improvement rate of JOA was divided into good group (n = 38) and bad group (n = 25). The improvement rate of JOA was 25 cases and the recovery rate was 74.51%. Between the two groups, There was no significant difference in preoperative JOA score and course of disease (P 0.05). The difference was statistically significant in T2 weighted imaging of intramedullary hyperintensity and residual rate of spinal canal area (P0. 009) and preoperative presence of 2 stool dysfunction (P0. 002). It was found that there was a close relationship between the lesion and the prognosis of patients with intramedullary hyperintensity, residual area of vertebral canal (OR13.286) and the presence of pre-operative dysfunction of defecation (OR25.905) on T 2-weighted images. [conclusion] posterior laminar decompression and internal fixation were effective in the treatment of thoracic OLF. The patients had high signal intensity in T 2 weighted imaging before operation, residual rate of vertebral canal area 鈮，

本文編號：1994818