title: Lamina osteotomy and replantation with miniplate fixation for thoracic myelopathy due to ossification of the ligamentum flavum.
abstract: Lamina osteotomy and replantation with miniplate fixation is often used to treat benign intradural tumors, effectively preventing nerve entrapment and postoperative spinal deformities. However, no studies report using this technique to treat thoracic myelopathy due to ossification of the ligamentum flavum (OLF). This article reports the clinical outcome of a series of 18 cases of contiguous multilevel OLF treated by lamina osteotomy and replantation with miniplate fixation.Eighteen consecutive patients at the authors' institution were treated between 2008 and 2010 for contiguous multilevel OLF. Clinical efficacy, operative time, blood loss, sagittal alignment, and complications were investigated. Japanese Orthopaedic Association scale scores improved from 4.7±1.4 preoperatively to 7.9±1.3 three months postoperatively and 8.8±1.3 at final follow-up (P<.01), with a mean recovery rate of 67.8%±13.1%. No significant kyphotic deformity occurred postoperatively, and local kyphosis in the treated area increased by a mean of only 1.9°±1.0° at final follow-up. No patient required additional surgery due to spinal canal reobstruction and progressive spinal deformity. Cerebrospinal fluid leakage occurred in 4 patients and resolved after repair. Pulmonary infection and deep venous thrombosis occurred in 1 patient who was discharged with no complications after routine treatment.Lamina osteotomy and replantation with miniplate fixation is an effective therapeutic option for thoracic myelopathy due to contiguous multilevel OLF compression. The technique provides adequate decompression and stabilized sagittal alignment and avoids invasion of the spinal canal by scar tissue.
authors: Department of Spine Surgery, the Third Hospital of HeBei Medical University, Shijiazhuang, China.
authors: Zhi-Hong
authors: ZH
authors: Nie
authors: Fa-Jing
authors: FJ
authors: Liu
authors: Yong
authors: Y
authors: Shen
authors: Wen-Yuan
authors: WY
authors: Ding
authors: Lin-Feng
authors: LF
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D006801:Humans; D017843:Ligamentum Flavum / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000150:complications / Q000601:surgery*; D010027:Osteotomy; D012092:Replantation; D013118:Spinal Cord Diseases / Q000601:surgery*; D013904:Thoracic Vertebrae