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Acta Neurochirurgica

, Volume 155, Issue 7, pp 1169–1177 | Cite as

Surgical results and prognostic factors for thoracic myelopathy caused by ossification of ligamentum flavum: posterior surgery by laminectomy

  • Shunzhi Yu
  • Dajiang Wu
  • Fengning Li
  • Tiesheng Hou
Clinical Article - Spine

Abstract

Background

Thoracic ossification of ligamentum flavum (TOLF) of the spine is characterized by a heterotopic bone formation in the thoracic ligamentum flavum, which causes slowly progressing spinal cord injury. Surgical decompression is the most common treatment of choice for patients with compressive myelopathy due to TOLF. However, the surgical outcome is not always satisfactory.

Methods

To identify the predictors of surgical outcome, we retrospectively studied the associations between various clinical and radiological parameters and postoperative recovery in 78 patients who underwent decompressive laminectomy for thoracic myelopathy due to TOLF between October 1998 and June 2011. Surgical outcomes were assessed using modified Japanese Orthopedic Association (mJOA) recovery rate (RR)/outcome scores.

Results

At a minimum of 1 year after surgery for TOLF treatment, the postoperative clinical scores showed statistically significant changes with improvement in the JOA scores. The results indicated that a longer duration of preoperative symptoms, fused-type TOLF, and the degree of compression of the anteroposterior diameter and ossified region (middle thoracic OLF) was related to poor prognosis.

Conclusion

Early diagnosis and sufficient surgical decompression improved the functional outcomes of TOLF patients. The surgical risk is relatively higher due to the tenuous blood supply of the spinal cord and the limited spinal canal volume of the middle thoracic spine extending from T4 to T9.

Keywords

Thoracic ossification of ligamentum flavum Compressive myelopathy Prognostic factor Middle thoracic spine 

Notes

Ethics statement

The study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards established in the 1964 Declaration of Helsinki and its later amendments. All participants provided informed consent prior to their inclusion in the study.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Shunzhi Yu
    • 1
  • Dajiang Wu
    • 1
  • Fengning Li
    • 1
  • Tiesheng Hou
    • 1
  1. 1.Department of Orthopedics, Changhai HospitalSecond Military Medical UniversityShanghaiPeople’s Republic of China

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