Clinical Study of Posterior Spinal Canal Resection and Internal Fixation Combined with Early Rehabilitation for Ossification of the Thoracolumbar Ligamentum Flavum
1.Department of Rehabilitation，Xuzhou Central Hospital
2.Department of Rehabilitation，Xuzhou Rehabilitation Hospital Affiliated to Xuzhou Medical University/ Xuzhou Rehabilitation Hospital
3.Department of Orthopedics，Xuzhou Central Hospital
Abstract：Objective To investigate the clinical effect of posterior wall resection and internal fixation combined with early rehabilitation in the application of thoracolumbar ossification of the ligamentum flavum.Methods The clinical data of 32 patients with thoracolumbar ligamentum flavum ossification admitted to Xuzhou Central Hospital from January 2010 to January 2020 were systematically retrospectively analyzed.17 males and 15 females were included.The patients aged 42 to 74 years，with an average age of (56.0±8.2)years old.All patients underwent thoracolumbar posterior spinal canal resection and internal fixation and early rehabilitation treatment.The pain visual analog scale (VAS)，local kyphosis angle，and Japanese orthopedics were recorded before operation and at the last follow-up.The Japanese orthopaedic association (JOA)score was used to evaluate the effect of surgical treatment and analyze the occurrence of complications.Results All patients were followed up for 18 to 57 months，with an average follow-up time of (34.8±8.6)months.The VAS score of the lower back at follow-up was lower than that before operation (P＜0.05).The local kyphosis angle of the patient before operation was (16.85±6.22)°，and the local kyphosis angle at last follow-up was (14.54±5.34)°.The difference was not statistically significant (P＞0.05).The preoperative JOA score was (5.23±1.12)，and the JOA score at the last follow-up was (8.15±1.34)，and the JOA score at the last follow-up was significantly improved compared with preoperative (P＜0.05).The surgical results were excellent in 15 cases，good in 8 cases，fair in 7 cases，and no improvement in 2 cases.Conclusion Posterior wall resection and internal fixation combined with early rehabilitation are effective in treating thoracolumbar ossification of the ligamentum flavum.It can significantly improve the patient’s neurological symptoms，reduce postoperative thoracolumbar kyphosis，and effectively reduce postoperative lumbar back pain.Long-term efficacy still needs the support of multi-center large sample randomized controlled clinical trials.
姜效韦 1，2，3，刘娜 1，张杨梅 1，马超 3，刘磊 3，拾坤 3，井贵龙 2*. 椎管后壁切除内固定结合早期康复治疗胸腰段黄韧带骨化症的临床研究[J]. 实用骨科杂志, 2022, 28(4): 305-316.
Jiang Xiaowei 1，2，3，Liu Na 1，Zhang Yangmei 1，Ma Chao 3，Liu Lei 3，Shi Kun 3，Jing Guilong 2*. Clinical Study of Posterior Spinal Canal Resection and Internal Fixation Combined with Early Rehabilitation for Ossification of the Thoracolumbar Ligamentum Flavum. sygkzz, 2022, 28(4): 305-316.
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