資源描述：
《黃韌帶骨化癥型胸椎管狹窄癥的臨床特點及手術(shù)治療【臨床醫(yī)學(xué)專業(yè)論文設(shè)計】》由會員上傳分享，免費在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫。
1、臨床醫(yī)學(xué)論文-黃韌帶骨化癥型胸椎管狹窄癥的臨床特點及手術(shù)治療【摘要】［目的］探討黃韌帶骨化癥型胸椎管狹窄癥(OLF-TSS)的臨床特點及手術(shù)治療效果。［方法］1998年10月?2007年2月采用整塊半關(guān)節(jié)突全椎板切除術(shù)治療38例OLF-TSS患者。其中男25例，女13例;年齡29?71歲，平均48歲。病變位于T10?L13個椎間盤水平31例(￡81.6%)。平均病程10個月。5.3%合并胸椎間盤突出。［結(jié)果］38例患者全部獲得隨訪1?8年，平均3年6個月。4例術(shù)中發(fā)生硬脊膜損傷;3例術(shù)后發(fā)生腦脊液漏，均經(jīng)以俯臥位為主的綜合保守治療后痊愈。按照王自立臨床療效評價標準，優(yōu)25例
2、，良11例，無改變2例，優(yōu)良率94.7%°未出現(xiàn)定位錯誤和神經(jīng)功能惡化者。［結(jié)論］OLF?TSS臨床表現(xiàn)復(fù)雜，常見癥狀包括下肢麻木無力、腰背痛、間歇性跛行、束帶感和括約肌功能障礙。癥狀和體征結(jié)合X線、MRI及CT檢查是確診的有效手段。采用整塊半關(guān)節(jié)突全椎板切除術(shù)進行胸椎管后壁減壓是安全、有效的方法。減少失誤和并發(fā)癥的對策是確定責任節(jié)段和規(guī)范手術(shù)操作?！娟P(guān)鍵詞】黃韌帶骨化癥；胸椎管狹窄癥；外科治療Abstract:［ObjectiveJToevaluatetheclinicalcharacteristicsandeffectofoperativetreatmentforthe
3、ossificationof1igamentumflavumthoracicspinalstenosis(OLF-TSS).［Methods］FromOctober1998toFebruary2007,38patientswith0LF?TSSweretreatedwithcnblochemi-articularprocesslaminectomy.Inthisgroup,25casesweremale,and13caseswerefemale?Theaverageagewas48years(range,29?71years).Totally81.6%ofthelesion
4、wasbetweenT10?LIintervertebraldiscspace.Theaveragehistorywas10months.Therewere5.3percentwithprotrusionofintervertebraldiscofthoraciospine.[Rcsults]Thirty-eighteaseswerefollowed?upfor1?8years,withanaverageof3yearsand6months.Duralinjuryoccurredin4casesof38,3casesappearedpostoperativecerebros
5、pinalfluidleakage.Al1caseswerecuredconservativelymainlywithbedrestintheprostrateposition.AccordingtoWANG'sevaluation,25hadexcellentresults,11hadgoodrcsults,2hadnochangeandnonewaspoor,Theexcellenttogoodratewas94.7%inthisgroup.Therewerenopatientswiththewrongleve1.Nopatientneurologicalfunctio
6、nsweredeteriorated.[ConclusionJThechinicalfeaturesof0LF?TSSareverycomplex?Thecommonsymptomsofthediseaseareprogressiveonsetofnumbness,weakness,lowbackpain,intermittentclaudicationofthe1owerextremities,constrictionontrunkor1ower1imbsandsphincterdysfunction.Theclinicalpresentationandneurologi
7、calexaminationassociatedwithX-rayfilm,MRIandCTweretheimportantmeansofthediagnosisofthedisease.Removaloftheposteriorwal1ofthethoracicspinalcanalviathetechniqueofenblochemi?articularprocesslaminectomyissafeandeffectivetotreat0LF?TSS.Thestrategyfordiminishingfaul
