目的：研究胸椎黄韧带骨化（ossification of the ligamentum flavum,OLF）发生年龄、节段分布、形态变化等的流行病学特点。方法：回顾性分析2010年2月以胸部症状来我院就诊的993例患者（男506,女487,年龄5～102岁,平均60岁）的胸部多...目的：研究胸椎黄韧带骨化（ossification of the ligamentum flavum,OLF）发生年龄、节段分布、形态变化等的流行病学特点。方法：回顾性分析2010年2月以胸部症状来我院就诊的993例患者（男506,女487,年龄5～102岁,平均60岁）的胸部多排探测CT（multidetector computed tomography,MDCT）片、轴位片结合矢状位CT片,分析胸椎黄韧带骨化的患病率及发生的节段、厚度、位置、硬膜囊压迫等情况,观察性别、年龄及发生节段等与OLF的关系。患病率采用《北京市2008年人口年龄构成统计》进行人群标化。结果：总体标化患病率为63.9%;男性标化患病率（68.5%）高于女性（59.0%）;50~59岁年龄组的患病率最高（79.2%）,但10~19岁人群也有OLF发生,其患病率为50.0%;T10~T11（44.0%）和T11~T12（41.6%）节段OLF的患病率亦较高。结论：被调查人群中,胸椎OLF患病率较高,出现年龄较早,发生于下胸段多于中上胸段,患病率与年龄具有一定的相关性。展开更多
Various surgical approaches have been successfully used in the treatment of thoracolumbar disc herniation （TLDH）. Although the anterior transthoracic approach has a reputation for better visualization than the poste...Various surgical approaches have been successfully used in the treatment of thoracolumbar disc herniation （TLDH）. Although the anterior transthoracic approach has a reputation for better visualization than the posterolateral and lateral approaches, it involves the manipulation of the thoracic and pulmonary structures. Thus, this approach is technically demanding and prone to compromising the respiratory system. An ideal approach would involve adequate visualization and be accomplished through the posterior midline approach that is familiar to spine surgeons. The objective of this retrospective preliminary clinical study was to introduce a new surgical procedure, circumspinal decompression through a single posterior incision, for the treatment of TLDH （T10/11-L1/2） and to evaluate the surgical outcome of this procedure by comparing it to the conventional anterior transthoracic approach. Methods In this study, 15 patients （10 males, 5 females; mean age 51 years） with symptomatic TLDH underwent the circumspinal decompression through a single posterior incision procedure between January 2008 and December 2009. Altogether, 17 herniated discs were excised, with 2 discs at T10/11, 4 discs at Tll/12, 5 discs at T12/L1 and 6 discs at L1/2. Of these patients, 13 were followed up with a mean follow-up period of 23.5 months. Clinical outcomes, including operative time, blood loss, perioperative complications, postoperative time of hospitalization, neurologic status improvement, back pain and correction of local kyphosis, were investigated by comparing these data with the results from patients who underwent the anterior transthoracic approach for TLDH during the same period. The patients＇ neurologic status was evaluated by a modified Japanese Orthopedic Association （JOA） scoring system of 11 points. Neurologic status improvement after the surgery was assessed by calculating the recovery rate, which was equal to the （postoperative JOA score-preoperative JOA score）/（11-preoperative JOA score）×100%. Th展开更多
文摘目的：研究胸椎黄韧带骨化（ossification of the ligamentum flavum,OLF）发生年龄、节段分布、形态变化等的流行病学特点。方法：回顾性分析2010年2月以胸部症状来我院就诊的993例患者（男506,女487,年龄5～102岁,平均60岁）的胸部多排探测CT（multidetector computed tomography,MDCT）片、轴位片结合矢状位CT片,分析胸椎黄韧带骨化的患病率及发生的节段、厚度、位置、硬膜囊压迫等情况,观察性别、年龄及发生节段等与OLF的关系。患病率采用《北京市2008年人口年龄构成统计》进行人群标化。结果：总体标化患病率为63.9%;男性标化患病率（68.5%）高于女性（59.0%）;50~59岁年龄组的患病率最高（79.2%）,但10~19岁人群也有OLF发生,其患病率为50.0%;T10~T11（44.0%）和T11~T12（41.6%）节段OLF的患病率亦较高。结论：被调查人群中,胸椎OLF患病率较高,出现年龄较早,发生于下胸段多于中上胸段,患病率与年龄具有一定的相关性。
文摘Various surgical approaches have been successfully used in the treatment of thoracolumbar disc herniation （TLDH）. Although the anterior transthoracic approach has a reputation for better visualization than the posterolateral and lateral approaches, it involves the manipulation of the thoracic and pulmonary structures. Thus, this approach is technically demanding and prone to compromising the respiratory system. An ideal approach would involve adequate visualization and be accomplished through the posterior midline approach that is familiar to spine surgeons. The objective of this retrospective preliminary clinical study was to introduce a new surgical procedure, circumspinal decompression through a single posterior incision, for the treatment of TLDH （T10/11-L1/2） and to evaluate the surgical outcome of this procedure by comparing it to the conventional anterior transthoracic approach. Methods In this study, 15 patients （10 males, 5 females; mean age 51 years） with symptomatic TLDH underwent the circumspinal decompression through a single posterior incision procedure between January 2008 and December 2009. Altogether, 17 herniated discs were excised, with 2 discs at T10/11, 4 discs at Tll/12, 5 discs at T12/L1 and 6 discs at L1/2. Of these patients, 13 were followed up with a mean follow-up period of 23.5 months. Clinical outcomes, including operative time, blood loss, perioperative complications, postoperative time of hospitalization, neurologic status improvement, back pain and correction of local kyphosis, were investigated by comparing these data with the results from patients who underwent the anterior transthoracic approach for TLDH during the same period. The patients＇ neurologic status was evaluated by a modified Japanese Orthopedic Association （JOA） scoring system of 11 points. Neurologic status improvement after the surgery was assessed by calculating the recovery rate, which was equal to the （postoperative JOA score-preoperative JOA score）/（11-preoperative JOA score）×100%. Th
