Surgical Outcomes of Thoracic Myelopathy Secondary to Ossification of Ligamentum Flavum in a Regional Hospital: A Primitive Report and Literature Review: 在一所地區醫院用手術治療由黃韌帶骨化引起的胸椎脊髓病的效果 - 報告及文獻回顧

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• 作者：Eleanor Wen ; ^{we661@ha.org.hk" class="auth_mail" title="E-mail the corresponding author} ; Ka Ki Ho ; Ka Kin Cheung
• 关键词：clinical outcome ; laminectomy ; ossification of ligamentum flavum ; ossification of posterior longitudinal ligament ; thoracic myelopathy
• 刊名：Journal of Orthopaedics, Trauma and Rehabilitation
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：21
• 期：Complete
• 页码：24-29
• 全文大小：1231 K

文摘

Symptomatic thoracic stenosis is an uncommon disease in contrast to cervical and lumbar stenosis. It has been reported that ossification of ligamentum flavum (OLF) is the most common cause of thoracic myelopathy in our locality.

Materials and methods

All patients with symptomatic thoracic spinal stenosis secondary to OLF who underwent operative treatment in our institution between January 1999 and December 2013 were retrospectively reviewed for demographic data, causes, complications and surgical outcomes.

Results

Twenty-six patients who underwent surgical treatment for symptomatic OLF were followed up for an average period of 71.3 months. All patients received decompression with concomitant instrumented fusion in 2 patients (7.7%). In our series, we had 2 cases (7.7%) of early post-operative neurological deterioration secondary to haematoma formation. Four cases (15.4%) were complicated with cerebrospinal fluid leakage. Operative outcome was reported in Frankel classification and modified Japanese Orthopedic Association (JOA) scale for thoracic myelopathy. After operation, 8 patients (30.8%) showed improvement in their Frankel grade, while 16 patients (61.5% ) had no change and 2 patients (7.7%) reported deterioration. Mean JOA score showed significant improvement from 5.1 (range 2–8) to 6.9 post-operatively (range 2–11).

Discussion and conclusion

OLF is the most common cause of thoracic myelopathy in our locality. Early accurate diagnosis and adequate surgical decompression are important for favourable outcomes despite operative difficulties and possible complications.