KẾT QUẢ PHẪU THUẬT GIẢI ÉP HẸP ỐNG SỐNG NGỰC DO CỐT HOÁ DÂY CHẰNG VÀNG CÓ TỔN THƯƠNG TUỶ SỬ DỤNG KHOAN MÀI Ở BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objectives: To evaluate the outcomes of decompression surgery for thoracic spinal stenosis with myelopathy caused by ossification of the ligamentum flavum, using a high-speed drill at the Spine Surgery Department of Viet Duc University Hospital from January 2023 to January 2025. Methods: This was a prospective, longitudinal, and descriptive study. Results: Among the patients in the study, the male-to-female ratio was 1.7:1, with a mean age of 53.6 ± 10.9 years. Surgical details included: an average of 2.1 ± 1.3 decompressed levels, a mean operative time of 65.8 ± 18.2 minutes, an average blood loss of 256.7 ± 50.8 mL, and a mean hospital stay of 5.4 ± 2.6 days. Postoperative outcomes were primarily good and fair, accounting for 51.7% and 36.6% of patients, respectively. Complications included spinal cord injury (3.3%), dural tears (5%), postoperative cerebrospinal fluid (CSF) leakage (1.7%), and epidural hematoma (3.3%). Incisional infection and delayed bone fusion each accounted for 1.7% of complications, and implant failure was 1.7% as well. Conclusion: Thoracic spinal stenosis is an uncommon condition with insidious progression that can lead to severe spinal cord compression and injury. Surgical decompression of the thoracic spinal cord carries a high risk of intraoperative and postoperative neurological injury, which presents a major challenge for surgeons. The use of a high-speed drill helps to limit the risk of spinal cord injury and dural tears during surgery.