Thoracic myelopathy in Japan: epidemiological retrospective study in Miyagi Prefecture during 15 years.
Thoracic myelopathy is defined as spinal cord compression in the thoracic region, leading to sensory and motor dysfunctions in the trunk and lower extremities, and can be caused by various degenerative processes of the spine. Thoracic myelopathy is rare, and there are many unsolved problems including its epidemiological and clinical features. We have established a registration system of spinal surgeries, which covered almost all surgeries in Miyagi Prefecture, and enrolled the data of 265 patients with thoracic myelopathy from 1988 to 2002. The annual rate of surgery gradually increased and averaged 0.9 per 100,000 inhabitants, which was less than 1/10 of that for cervical myelopathy. About 20 patients with thoracic myelopathy are operated on in Miyagi Prefecture each year. It frequently develops in middle-aged males. About half of the cases were caused by ossification of the ligamentum flavum, followed by ossification of the posterior longitudinal ligament, intervertebral disc herniation and posterior spur. Patients usually noticed numbness or pain in the legs and the preoperative duration was long, averaging 2 years. Its symptomatic similarities to lumbar disorders might cause difficulty in making a correct diagnosis. Since thoracic myelopathy can markedly restrict the activities of daily life, even general physicians should recognize this entity.
Aizawa
Toshimi
T
Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan. toshi-7@ra2.so-net.ne.jp
Sato
Tetsuro
T
Tanaka
Yasuhisa
Y
Ozawa
Hiroshi
H
Hoshikawa
Takeshi
T
Ishii
Yushin
Y
Morozumi
Naoki
N
Ishibashi
Kentaro
K
Kasama
Fumio
F
Hyodo
Hironori
H
Murakami
Eiichi
E
Nishihira
Takeshi
T
Kokubun
Shoichi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan; D017843:Ligamentum Flavum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000473:pathology; D017887:Ossification of Posterior Longitudinal Ligament / Q000473:pathology; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000473:pathology; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D013896:Thoracic Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D016896:Treatment Outcome