title: Lamina Fenestration Technique for Treatment of Thoracic Ossified Ligamentum Flavum: 2-Year Follow-Up Result.
abstract: BackgroundThe incidence of thoracic ossification of ligamentum flavum (OLF) is increasing, and the available surgical techniques were invasive.Study AimsTo evaluate the surgical outcome and prognostic factors in relation to clinicoradiologic variables with a novel minimally invasive lamina fenestration technique in patients with thoracic OLF.Patients and MethodsBetween July 2005 and November 2010, 27 levels with 50 lesions in 17 patients were treated with the lamina fenestration technique for the decompression of thoracic OLF. This technique creates a keyhole in the lamina, preserving lower lamina bone, facet joint, and ligamentum flavum. Patient outcome was analyzed using the Japanese Orthopaedic Association (JOA) score and progression of kyphosis on simple X-ray.ResultsAll patients were successfully treated with the laminar fenestration technique. There was one dural tear but no neural complication or injury. Mean length of follow-up was 49 months. Mean JOA score improved from 4.88 to 7 (p= 0.000). Six patients had an excellent surgical outcome; 10 had a good surgical outcome according to JOA scoring.ConclusionThe lamina fenestration technique for the treatment of thoracic OLF had a successful outcome with few complications. This technique can be a minimally invasive surgical option for the treatment of thoracic OLF.
authors.affiliation: Department of Orthopaedics, Spine Health Wooridul Hospital, Gangnam-gu, Seoul, the Republic of Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Eun
authors.affiliation: Department of Orthopaedics, Spine Health Wooridul Hospital, Gangnam-gu, Seoul, the Republic of Korea.
authors.forename: Ramakant
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Gangnam-gu, Seoul, the Republic of Korea.
authors.forename: Won Gyu
authors.initials: WG
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Gangnam-gu, Seoul, the Republic of Korea.
authors.forename: Hyung Rae
authors.initials: HR
authors.lastname: Cho
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Gangnam-gu, Seoul, the Republic of Korea.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D017843:Ligamentum Flavum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D016896:Treatment Outcome