| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 4072525 | Journal of Orthopaedics, Trauma and Rehabilitation | 2016 | 6 Pages |
IntroductionSymptomatic thoracic stenosis is an uncommon disease in contrast to cervical and lumbar stenosis. It has been reported that ossification of ligamentum flavum (OLF) is the most common cause of thoracic myelopathy in our locality.Materials and methodsAll patients with symptomatic thoracic spinal stenosis secondary to OLF who underwent operative treatment in our institution between January 1999 and December 2013 were retrospectively reviewed for demographic data, causes, complications and surgical outcomes.ResultsTwenty-six patients who underwent surgical treatment for symptomatic OLF were followed up for an average period of 71.3 months. All patients received decompression with concomitant instrumented fusion in 2 patients (7.7%). In our series, we had 2 cases (7.7%) of early post-operative neurological deterioration secondary to haematoma formation. Four cases (15.4%) were complicated with cerebrospinal fluid leakage. Operative outcome was reported in Frankel classification and modified Japanese Orthopedic Association (JOA) scale for thoracic myelopathy. After operation, 8 patients (30.8%) showed improvement in their Frankel grade, while 16 patients (61.5% ) had no change and 2 patients (7.7%) reported deterioration. Mean JOA score showed significant improvement from 5.1 (range 2–8) to 6.9 post-operatively (range 2–11).Discussion and conclusionOLF is the most common cause of thoracic myelopathy in our locality. Early accurate diagnosis and adequate surgical decompression are important for favourable outcomes despite operative difficulties and possible complications.
中 文 摘 要簡介相對於頸椎和腰椎管狹窄症,胸椎管狹窄是罕見的疾病。以前的研究指出,黃韌帶的骨化 (ossification of ligamentum flavum, OLF) 是在本地引致胸椎脊髓病的最常見原因。材料和方法我們回顧了從 1999 年 1 月和 2013 年 12 月間, 因黃韌帶骨化引致胸椎管狹窄症而在本院接受手術治療的病人。我們回顧分析了病人資料數據,術後併發症和手術結果。結果共有 26 位病人接受手術治療,平均隨訪週期為 71.3 個月。所有病人均接受減壓手術,當中有 2 例 (7.7%) 伴隨脊椎融合和內固定。在我們的病人中,有 2 例出現術後血腫形成引致早期神經功能惡化 (7.7%), 有 4 例 (15.4%) 出現腦脊液漏出。手術結果以 Frankel 分級和修訂版日本骨科協會分數 (JOA) 來作評定。手術後, 8 例 (30.8%) Frankel 分級有所改善, 16 例 (61.5%) 無明顯變化, 2 例 (7.7%) 有所惡化。平均 JOA 分數有著顯著的改善,從術前 5.1 分 (範圍 2-8 分) 升至術後 6.9 分 (範圍 2-11 分)。討論和結論黃韌帶的骨化是在本地引致胸椎脊髓病的最常見原因。儘管技術困難和可能出現的併發症,早期準確診斷和適當的手術減壓對取得良好結果是非常重要的。
