Surgery for thoracic myelopathy caused by ossification of the ligamentum flavum.
Between January 1996 and December 2003, our department treated 16 patients (10 men and 6 women; average age 57.5 years) by performing a laminectomy for thoracic myelopathy caused by ossification of the ligamentum flavum (OLF). We followed up all patients for 36 to 86 months (mean follow-up time, 57.3 months). The mean (+/-standard deviation) Japanese Orthopaedic Association score increased from 5.0+/-1.4 points before the operation to 7.7+/-1.9 points at the last follow-up (p<0.01). The average values for pre-operative and post-operative kyphosis of the involved vertebrae were 5.8 degrees +/-4.1 degrees and 8.8 degrees +/-6.0 degrees , respectively; the mean increase in kyphosis was only 3.0 degrees +/-2.4 degrees . An intraoperative dural tear was the main complication and none of the patients developed severe neurological complications. We conclude that laminectomy was both effective and safe in the treatment of thoracic OLF, but it must be performed with great care because of frequent dural adhesions to the OLF. The increase in kyphosis after the laminectomy was minimal when most of the facet joints were left intact and when the patient followed a back extensor exercise program post-operatively.
Chen
Xiao-Qing
XQ
Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Yang
Hui-Lin
HL
Wang
Gen-Lin
GL
Gu
Yong
Y
Pan
Wen-Ming
WM
Dong
Ren-Bin
RB
Qiu
Zhi-Jie
ZJ
Wu
Ji-Bin
JB
Mei
Xin
X
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007796:Laminectomy; D017843:Ligamentum Flavum / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000150:complications* / Q000473:pathology; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome