Objective To investigate the clinical outcomes of posterior circular decompression to treat thoracic disk herniation combined with ossification. Methods Twenty-five patients who had thoracic disk herniation combined with ossification underwent the procedure of posterior circular decompression. The lesion segment was T4/5、T5/6 in 2 cases, T6/7 in 1case, T8/9 in 2 cases, T9/10 in 4 cases, T10/11 in 6 cases and T11/12 in 8 cases. The postoperative curative effect was measured by JOA score and Otani scoring system. Results The average operative time was (175.7±12.4) min with a mean blood loss was (630.8±33.7) ml. Five patients exhibited intraoperative cerebrospinal fluid leakage, and recovered after treatment. One case developed wound hematoma and recovered after an emergency debridement. Compared with the preoperative level (6.3±2.1), the JOA score had a significant recovery at 3 months (9.4±3.0) and at the last follow-up (9.7±3.3)(P<0.05). The Otani score at the last follow-up was excellent in 13 patients, good in 8 patients, fair in 3 patients, and poor in 1 patient, and the good response rate was 84.0%. Conclusions The posterior circular decompression in treating thoracic disk herniation combined with ossification can obtain good clinical results. However, attention should be paid to avoid cerebrospinal fluid leakage.
Key words
thoracic vertebra /
thoracic disk herniation /
circular decompression /
analysis of effect
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 丁文元,李 华.症状性胸椎间盘突出症手术治疗进展[J]. 中国矫形外科杂志, 2006, 14(16): 1228-1231.
[2] 杨大龙,申 勇,张英泽, 等. 经后路改良“蛋壳”技术治疗硬化性胸椎间盘突出症[J]. 中华骨科杂志, 2011, 31(8): 829-833.
[3] Liu F J,Chai Y,Shen Y, et al. Posterior decompression with transforaminal interbody fusion for thoracic myelopathy due to ossification of the posterior longitudinal ligament and the ligamentum flavum at the same level [J]. J Clin Neurosci,2013, 20(4): 570-575.
[4] 丁文元, 李宝俊, 申 勇, 等. 经后外侧入路治疗胸椎间盘突出症38例报告 [J]. 中华骨科杂志, 2006, 26(1): 39-42.
[5] Hur H, Lee J K, Lee J H, et al. Thoracic myelopathy caused by ossification of the ligamentum flavum[J]. Korean Neurosurg Soc, 2009, 46(3): 189-194.
[6] Otani K, Yoshida M, Fujii E, et al. Thoracic disc herniation: surgical treatment in 23 patients [J]. Spine,1988, 13(11): 1262-1267.
[7] 程立明, 蔡道章, 陈仲强, 等. 胸椎间盘突出症患者病变节段分布及其生物力学变化: 57例临床资料及10年国内文献数据比较[J]. 中国临床康复, 2004, 8(35): 7924-7926.
[8] 熊 伟,李 锋, 霍喜卫, 等. 经关节突减压融合治疗腹侧压迫型胸椎管狭窄症[J]. 中华骨科杂志, 2010, 30(11): 1082-1086.
[9] Qi Q, Chen Z Q, Liu N, et al. Circumspinal decompression through a single posterior incision to treat thoracolumbar disc herniation [J]. Chin Med J (Engl), 2011, 124(23): 3852-3857.
[10] 胡 健,程 冲,尚卫明,等. 60例多发骨折并发休克患者急救[J]. 中国急救复苏与灾害医学杂志, 2013, 8(10):949-950.
[11] Wang L F, Liu F J, Zhang Y Z, et al. Clinical results and intramedullary signal changes of posterior decompression with transforaminal interbody fusion for thoracic myelopathy caused by combined ossification of the posterior longitudinal ligament and ligamentum flavum[J]. Chin Med J (Engl), 2013, 126(20): 3822-3827.
[12] 李 波, 陈喜安. 腰大池置管持续引流治疗脊柱术后脑脊液漏的疗效分析[J]. 中国脊柱脊髓杂志, 2011, 21(6): 456-458.