Zhonghua Yi Xue Za Zhi. 2026 Aug 11;106(29):3033-3039. doi: 10.3760/cma.j.cn112137-20260519-01340.
ABSTRACT
Objective: To explore the clinical efficacy and application value of O-arm navigation-assisted zoning laminectomy in the treatment of severe thoracic ligamentum flavum ossification (TOLF). Methods: A retrospective cohort study was conducted to analyze 83 patients with severe TOLF admitted to Zhengzhou Orthopedic Hospital from May 2019 to August 2023. There were 48 males and 35 females, the age was (50.1±6.0) years. Preoperative three-dimensional reconstruction of the ossified ligamentum flavum in the thoracic spine was performed using Mimics 21.0 software for preoperative planning. According to different treatment methods, patients were divided into the O-arm navigation-assisted zoning laminectomy group (navigation group, n=41) and the simple zoning laminectomy group (control group, n=42). The baseline data, operation time, intraoperative blood loss and total hospital stay of the two groups were compared. The modified Japanese Orthopaedic Association (mJOA) score and improvement rate were used to evaluate the changes in neurological function before the operation, 1 month, 3 months after the operation and at the last follow-up. The occurrence of complications in the patients was recorded. Results: The 83 patients were followed up for (20.3±6.9) months. There was no statistically significant differences in gender, age, lesion involved segments and disease duration between the two groups (all P>0.05). The operation time of the navigation group was significantly shorter than that of the control group [(134.4±29.9) vs (152.9±30.2) min, P=0.006]. There were no statistically significant differences in intraoperative blood loss [(412.2±98.6) vs (433.3±80.1) ml] and total hospital stay [(7.8±1.5) vs (7.8±1.4) d] between the navigation group and the control group (both P>0.05). The mJOA scores of the navigation group at 1 month, 3 months after the operation and the last follow-up were significantly higher than the preoperative mJOA score (all P<0.001). There was no significant difference in mJOA scores between the two groups at each time point (all P>0.05). There was no statistically significant difference in therapeutic effect between the two groups (P=0.616). There was no significant difference in the improvement rate of mJOA between two groups [(67.8%±19.9%) vs (69.8%±19.3%), P=0.760]. There were 7 cases of cerebrospinal fluid leakage after the operation in the navigation group. In the control group, there were 11 cases of cerebrospinal fluid leakage and 1 case of transient neurological dysfunction. The incidence of postoperative complications in the navigation group was lower than that in the control group [(7/41, 17.1%) vs (12/42, 28.6%), P=0.035]. Conclusion: O-arm navigation-assisted technology helps achieve precise decompression during surgery, shortens the operation time and enhance the surgical safety.
PMID:42571970 | DOI:10.3760/cma.j.cn112137-20260519-01340
