摘要黄韧带骨化症(ossification of ligamenta flava,OLF)是脊柱韧带骨化性疾病的一种,是结蹄组织向骨性组织转化的过程。以胸段尤其是下胸段最为常见,颈椎和腰椎也可发生。胸段OLF是导致胸椎管狭窄症最常见的原因,主要表现为双下肢麻痹、无力及步态异常、感觉障碍及膀胱直肠功能障碍,常有膝踝反射亢进和下肢肌力减弱等体征。因其非手术治疗一般无效,手术是目前治疗该疾病唯一有效的选择。传统的后路手术面临创伤大、费用高、并发症多及恢复周期长等问题。近年来,随着微创技术的发展,显微内镜技术在治疗颈椎及腰椎退变性疾病方面已经取得显著疗效,但是由于胸椎与颈、腰椎相比解剖差异大,胸椎管储备空间有限,脊髓耐受性较差,且受肋骨和胸腔影响,因此能否采用显微内镜技术治疗胸椎管狭窄,国内外鲜有报道。本课题组对一位胸椎黄韧带骨化症患者应用经皮内镜技术进行手术,现将获得的初步体会作如下汇报,以探讨该技术在治疗胸椎黄韧带骨化引起胸椎管狭窄症方面的可行性以及治疗效果。
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