title: Analysis of the prevalence and distribution of cervical and thoracic compressive lesions of the spinal cord in lumbar degenerative disease.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  The aim of the present study is to analyze the prevalence and distribution of cervical and thoracic compressive lesions of the spinal cord in lumbar degenerative disease, using whole-spine postmyelographic computed tomography.
  
  
  BACKGROUND
  Of the various complications resulting from spinal surgery, unexpected neurological deterioration is the most undesired. There are reports of missed compressive lesions of the spinal cord at the cervical or thoracic level in lumbar degenerative disease.
  
  
  METHODS
  There were 145 consecutive patients with symptomatic lumbar degenerative disease evaluated. Before the lumbar surgery, image data were obtained. The following parameters at the cervical and thoracic levels were analyzed: compressive lesions from the anterior parts; compressive lesions from the anterior and posterior parts; ossification of the ligamentum flavum; ossification of the posterior longitudinal ligament; and spinal cord tumor.
  
  
  RESULTS
  Compressive lesions from the anterior parts were observed in 34 cases (23.4%). Compressive lesions from the anterior and posterior parts were observed in 34 cases (23.4%). Lesions of ossification of the ligamentum flavum were observed in 45 cases (31.0%). Lesions of ossification of the posterior longitudinal ligament were observed in 15 cases (10.3%). Spinal cord tumor was not observed.
  
  
  CONCLUSIONS
  A survey of compressive lesions at the cervical or thoracic level in lumbar degenerative disease is important in preventing unexpected neurological deterioration after the lumbar surgery.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Miyazaki
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Toyomi
authors.initials: T
authors.lastname: Yoshiiwa
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Kodera
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawano
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsumura
keywords: Cervical spine; Lumbar surgery; Neurological deterioration; Thoracic spine