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目的 总结黄韧带骨化所致胸椎管狭窄症的诊断和治疗特点, 探讨有关的发病因素.方法 1978~1997 年手术治疗黄韧带骨化所致胸椎管狭窄症患者35 例,男21 例,女14 例, 平均年龄51岁.发病部位:T10~L1 三个椎间盘水平30 例,占85-7%.重体力劳动者32 例,占91-4%.有明显诱因者16 例, 占45-7%.35 例患者临床症状呈多样化, 但感觉定位体征明确: 出现锥体束征者15 例, 占42-9%;未出现者13 例,占37-1%;单纯腱反射亢进4 例,占11-4%;单纯病理反射阳性2 例,占5-7%;腱反射亢进合并病理反射阳性1 例,占2-9%.影像学检查显示病变及非病变节段的椎间盘均为广泛退行性变. 结果 随访1~18 年,平均5 年7 个月.根据评定标准,前期16 例采用传统椎板减压术,随访12 例中,优5 例,良2 例,无改变3 例,差2 例;后期19 例采用整块半关节突全椎板切除术,均得到随访,其中优15 例,良4 例.结论 (1)胸椎黄韧带骨化可能与退变因素有关,其所致的胸脊髓压迫症临床表现复杂、多样.(2)整块半关节突全椎板切除术为治疗胸椎管狭窄症的有效术式“,”Objective To summarize the diagnosis and treatment of thoracic spinal canal stenosis caused by ossification of the ligamentum flavum (OLF) and discuss its ralated pathogenic factors Methods Thirty five cases of thoracic spinal canal stenosis caused by OLF undergone surgical treatment from 1978 to 1997 were studied, there were 21 males and 14 females,with the average age of 51 years 85 7% of the lesion was between T10-L 1 intervertebral disc space 91 4% of the patients were heavy physical labors, 45 7% had obvious predisposing causes and 20% had history of spinal osteopathy or fracture The symptoms were various while the locating signs were definite 42 9% of the cases had pyramidal signs, and 20% had one or two positive signs Extensive degenerative changes were shown both in lesional and the nonlesional sites on iconography Results Thirty one cases were followed up for 1-18 years, with an average of 5 years and 7 months According to the criterion, of 12 cases in early stage treated with traditional vertebral laminectomy, 5 had excellent results, 2 had good results, 3 had no change and the other 2 were poor Of 19 cases in advanced stage treated with en bloc hemi articular process laminectomy, 15 were excellent, 4 were good and none was poor or without change Conclusion 1)OLF has a very close relation with the degenerative changes,and cause the symptoms of thoracic spinal cord compression very colorful and complications 2)En bloc hemi articular process laminectomy is an effective surgical approach for the treatment of thoracic spinal canal stenosis