Clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degen-erativ diss

2011-08-15 00:54MaXunDeptOrthop2ndHospShanxiMedUnivTaiyuan030001ChinOrthop2010301111011104
外科研究与新技术 2011年2期

马 迅(Ma Xun,Dept Orthop,2nd Hosp Shanxi Med Univ,Taiyuan 030001)…∥Chin J Orthop.-2010,30(11).-1101~1104

Clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degen-erativ diss

马 迅(Ma Xun,Dept Orthop,2nd Hosp Shanxi Med Univ,Taiyuan 030001)…∥Chin J Orthop.-2010,30(11).-1101~1104

ObjectiveTo discuss clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease.MethodsFrom January 2004 to December 2008,79 cases with the coexistence of cervical,thoracic and lumber degenerative disease were surgi-cally treated,including 51 males and 28 females,aged from 30 to 80 years(average,58.1 years).All 79 cases presented coexistence of cervical,thoracic and lumbar compression symptoms,such as limb numbness,weakness,zonesthesia and positive Hoffmann and Babinski sign.Forty-one cases mainly presented cervical symptoms,5 presented thoracic symptoms and 12 presented lumbar symptoms.According to affected segments,41 cases received cervical operations,5 cases received thoracic operations,12 cases received lumber operations,and 21 cases received two parts operations.Surgical outcomes were evaluated by Japanese Orthopaedic Association(JOA)score.ResultsJOA score of all cases improved in varying degrees.The improvement rate of received cervical operation was 66.06% ± 14.33%,and that of received mere thoracic operation was 56.19% ± 9.85%,and that of lumbar operation was 63.49% ± 9.78%.Twenty-one cases received two parts operations.Forteen cases received one-stage two parts operations with improvement rate of 76.78% ±3.94%and 7 cases received two stage and two part operations with improvement rate of 71.79% ± 8.74%.ConclusionThe coexistence of cervical,thoracic and lumber degenerative disease is a kind of complex disease,which involves multi-segments and presents various clinical manifestations.The condition was caused by disk herniation,spinal stenosis and ossification of posterior longitudinal ligament and hypertrophy or ossification of ligamentum flavum.The optimal surgical procedures should be selected by integrated judgment of symptoms and imaging manifestations.11 refs,3 tabs.

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