分类号 - 第三军医大学学报.doc

胸椎黄韧带骨化症的临床特征及疗效影响因素分析 于晓飞，王伯鑫，柯珍勇* (重庆医科大学附属第二医院 骨科 400010 ) 【摘要】目的 探讨胸椎黄韧带骨化症(ossification of ligamentum flavum，OLF)的临床特征，评估影响术后疗效的重要因素。方法 对2001年6月～2010年6月期间住院治疗并获得随访的28例胸椎黄韧带骨化症患者进行了回顾性研究，运用术前、术后神经功能评价标准选用改良JOA评分(11分法)，疗效评价选用患者的术后恢复率，恢复率=(术后JOA评分-术前JOA评分)/(11-术前JOA评分)×100％来评估，恢复率在75％～100％为优，50％～74％为良，25％～49％为可，0～24％为差。疗效影响因素的分析采用用Pearson相关性分析，组内的比较采用t检验，a水准为0.05。结果 首发症状中以麻木（78.6%）和无力（71.4%）最为常见。平均术前及术后JOA评分分别为4.5 ± 2.2和8.5 ± 2.6（P＜0.05），平均术后恢复率为（59.2±28.2）％，术后恢复优良率78.6%，有效率（89.3%）。术前病程、JOA评分、脊髓信号改变与OLF术后早期诊断和的手术减压能功能与OLF术后 【关键词】 胸椎；黄韧带骨化；外科治疗；影响因素 Clinical characteristics and analysis of the factors related to outcome for the ossification of ligamentum flavum of thoracic spine Yu Xiao-fei，Wang Bo-xin，Ke Zhen-yong* Department of orthopedics，Second Affiliated Hospital of Chong Qing Medical University 400010 Chong Qing China Abstract：Objective To investigate the clinical characteristcs of the ossification of ligamentum flavum (OLF) of thoracic spine, and to analyze the factors related to outcome. Methods We studied 28 patients who underwent surgical treatment to thoracic OLF in the orthopedic department of the second affliated hospital of chongqing medical university from June of 2001 to June of 2010. Patients were evaluated pre- and postoperatively using the modified Japanese Orthopedic Association (JOA) scale (maximum total score of 11) and recovery rate (RR). And Pearson correlations were analyzed among RR and undermentioned parameters. Results The most common sympoms were numbness (78.6%) and motor dysfunction (71.4%) in the lower extremities. The mean preoperative JOA score of 4.5±2.2 improved to a mean score of 8.5±2.6 at the last follow-up. The mean RR was (59.2±28.2)%, and the excellent and good rate was 78.6%, fair rate 89.3%. Patients with short disease course, high preoperative JOA scores, and without intramedullary signal change on MRI had good surgical results. The patients whose disease course 6 months and preoperative JOA scores 3 had obviously