Clinical efficacy of single channel split body endoscopic minimally invasive surgery for single segment thoracic ossification of the ligamentum flavum
10.3760/cma.j.cn121113-20241022-00581
- VernacularTitle:单通道分体脊柱内镜手术与开放手术治疗单节段胸椎黄韧带骨化症的临床疗效
- Author:
Xiangyu LIN
1
;
Wanlong XU
;
Le LI
;
Wencan ZHANG
;
Chen LIU
;
Kunpeng LI
;
Bingtao HU
;
Chongyi WANG
;
Yunze FENG
;
Kaibin WANG
;
Haipeng SI
Author Information
1. 山东大学齐鲁医院骨科，济南 250012
- Publication Type:Journal Article
- Keywords:
Ligamentum flavum;
Minimally invasive surgical procedures;
Spinal stenosis;
One-hole split endoscope
- From:
Chinese Journal of Orthopaedics
2025;45(17):1111-1118
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of one-hole split endoscope (OSE) minimally invasive surgery for the treatment of single-segment thoracic ossification of the ligamentum flavum (TOLF).Methods:This retrospective non-randomized controlled study included 41 patients with single-segment TOLF who underwent surgery at Qilu Hospital of Shandong University between July 2019 and July 2023. Patients were divided into two groups: the OSE group (19 cases) treated with one-hole split endoscope minimally invasive surgery and the open group (22 cases) treated with traditional laminectomy and pedicle screw fixation. There were no significant differences between the two groups on gender, age, disease duration, affected segment, presence or absence of dural ossification, and residual cross-sectional vertebral canal area on CT ( P>0.05). Additionally, perioperative surgical time, estimated blood loss (EBL), incision length, hospital stay duration, hospitalization costs and follow-up duration were compared. The Japanese Orthopaedic Association (JOA) score and Oswestry Disability Index (ODI) were compared preoperatively and at the last follow-up. Complications were also recorded. Results:All patients successfully completed the surgery with no significant differences at the last follow-up ( P>0.05). Compared with the open group, the OSE group had a significantly shorter operative time (133.1±16.8 vs. 160.5±22.6 min), lower EBL (91.2±15.0 vs. 192.5±43.8 ml), shorter incision length (2.6±0.5 vs. 7.9±1.9 cm), reduced hospital stay (3.9±0.8 vs. 5.6±0.8 days), and lower hospitalization costs (34,874.9±4,568.6 vs. 53,162.3±9,815.6 yuan) (all P<0.05). AAt the final follow-up, JOA scores (8.5±0.8 vs. 8.6±1.2) and ODI values (16.7%±2.1% vs. 17.7%±4.4%) showed no significant differences between the OSE and open groups ( P>0.05). During the perioperative period and follow-up, complications occurred in 2 patients in the OSE group (1 cerebrospinal fluid leak, 1 poor wound healing) and in 8 patients in the open group (5 cerebrospinal fluid leaks, 1 neurological deterioration, 2 poor wound healing). Conclusion:OSE minimally invasive surgery is an effective treatment for single-segment thoracic ossification of the ligamentum flavum. Compared with open surgery, it provides advantages such as minimal invasiveness and fewer complications.
