European Spine Journal

, Volume 15, Issue 4, pp 485–491 | Cite as

Contributing factors affecting the prognosis surgical outcome for thoracic OLF

  • Sung Uk Kuh
  • Young Soo Kim
  • Yong Eun Cho
  • Byung Ho JinEmail author
  • Keun Su Kim
  • Young Sul Yoon
  • Dong Kyu Chin
Original Article


The thoracic ossification of ligamentum flavum (OLF) is a disease that produces spastic paraparesis, and there are various factors that may affect the surgical outcome of thoracic OLF patients. The authors of this study treated 19 of these thoracic OLF patients from 1998 to 2002, and retrospectively reviewed the patients′ age, sex, symptom duration, involved disease level, preoperative clinical features, neurological findings, radiological findings, the other combined spinal diseases and the surgical outcomes. There were excellent or good surgical outcomes in 16 patients, but 3 patients did not improve after thoracic OLF surgery: this included 1 patient, whose motor function worsened after decompressive thoracic OLF surgery. The favorable contributing factors of surgical outcome in thoracic OLF are a short preoperative symptom duration, single-level lesion, and unilateral lesion type on CT axial scan. On the contrary, the poor prognostic factors are beak type lesion and intramedullary signal changes on T2-weighted sagittal MRI. The complete preoperative evaluation including radiologic findings will provide valuable aid in presuming the surgical outcome for the thoracic OLF patients.


Thoracic Spine Stenosis Ossification of ligament flavum Myelopathy Surgical Outcome 


  1. 1.
    Ben Hamouda K, Jemel H, Haouet S, Khaldi M (2003) Thoracic myelopathy caused by ossification of the ligamentum flavum: a report of 18 cases. J Neurosurg 99:157–161PubMedGoogle Scholar
  2. 2.
    Chang UK, Choe WJ, Chung CK, Kim HJ (2001) Surgical treatment for thoracic spinal stenosis. Spinal Cord 39:362–369CrossRefPubMedGoogle Scholar
  3. 3.
    Enomoto H, Kuwayama N, Katsumata T, Doi T (1988) Ossification of the ligamentum flavum. A case report and its MRI finding. Neuroradiology 30:571–573CrossRefPubMedGoogle Scholar
  4. 4.
    Epstein NE (1999) Ossification of the yellow ligament and spondylosis and/or ossification of the posterior longitudinal ligament of the thoracic and lumbar spine. J Spinal Disord 12:250–256PubMedGoogle Scholar
  5. 5.
    Fong SY, Wong HK (2004) Thoracic myelopathy secondary to ligamentum flavum ossification. Ann Acad Med Singapore 33:340–346PubMedGoogle Scholar
  6. 6.
    Gil-Salu JL, Lopez-Escobar M, Gomez-Cardenas E, Rodriguez-Pena F, Repeto-Lopez JA, Lopez Lopez J, Garcia-Vazquez F (2002) Calcification of the thoracic yellow ligament as a cause of myelopathy. Rev Neurol 34:750–753PubMedGoogle Scholar
  7. 7.
    Hanakita J, Suwa H, Nagayasu S, Nishi S, Ohta F, Sakaida H (1991) Clinical analysis of ossified thoracic ligaments and thoracic disc hernia. Neurol Med Chir (Tokyo) 31:936–942Google Scholar
  8. 8.
    Kudo S, Ono M, Russell WJ (1983) Ossification of thoracic ligamenta flava. AJR Am J Roentgenol 141:117–121PubMedGoogle Scholar
  9. 9.
    Miyakoshi N, Shimada Y, Suzuki T, Hongo M, Kasukawa Y, Okada K, Itoi E (2003) Factors related to long-term outcome after decompressive surgery for ossification of the ligamentum flavum of the thoracic spine. J Neurosurg 99:251–256PubMedGoogle Scholar
  10. 10.
    Nishiura I, Isozumi T, Nishihara K, Handa H, Koyama T (1999) Surgical approach to ossification of the thoracic yellow ligament. Surg Neurol 51:368–372CrossRefPubMedGoogle Scholar
  11. 11.
    Parekh HC, Gurusinghe NT, Perera SS, Prabhu SS (1993) Ossification of the ligamentum flavum in a Caucasian: case report. Br J Neurosurg 7:687–690PubMedGoogle Scholar
  12. 12.
    Shiokawa K, Hanakita J, Suwa H, Saiki M, Oda M, Kajiwara M (2001) Clinical analysis and prognostic study of ossified ligamentum flavum of the thoracic spine. J Neurosurg 94:221–226PubMedGoogle Scholar
  13. 13.
    Takeuchi A, Miyamoto K, Hosoe H, Shimizu K (2004) Thoracic paraplegia due to missed thoracic compressive lesions after lumbar spinal decompression surgery. Report of three cases. J Neurosurg 100:71–74PubMedGoogle Scholar
  14. 14.
    Trivedi P, Behari S, Paul L, Banerji D, Jain VK, Chhabra DK (2001) Thoracic myelopathy secondary to ossified ligamentum flavum. Acta Neurochir (Wien) 143:775–782CrossRefGoogle Scholar
  15. 15.
    Vasudevan A, Knuckey NW (2002) Ossification of the ligamentum flavum. J Clin Neurosci 9:311-313CrossRefPubMedGoogle Scholar
  16. 16.
    Xiong L, Zeng QY, Jinkins JR (2001) CT and MRI characteristics of ossification of the ligamenta flava in the thoracic spine. Eur Radiol 11:1798–1802CrossRefPubMedGoogle Scholar
  17. 17.
    Yatsuzuka H, Kitajima T, Taguchi Y, Sakai H, Nakamura N (1986) A case of ossified yellow ligaments (ossified ligamenta flava) of the thoraco-lumbar region and magnetic resonance imaging.No Shinkei Geka 14:1121–1125PubMedGoogle Scholar
  18. 18.
    Yonenobu K, Ebara S, Fujiwara K, Yamashita K, Ono K, Yamamoto T, Harada N, Ogino H, Ojima S (1987) Thoracic myelopathy secondary to ossification of the spinal ligament. J Neurosurg 66:511–518PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Sung Uk Kuh
    • 1
  • Young Soo Kim
    • 2
  • Yong Eun Cho
    • 1
  • Byung Ho Jin
    • 1
    Email author
  • Keun Su Kim
    • 1
  • Young Sul Yoon
    • 1
  • Dong Kyu Chin
    • 1
  1. 1.Yongdong Severance Hospital, Department of NeurosurgeryYonsei University, Medical CollegeSeoulKorea
  2. 2.Kwanghye Spine CenterKwanghye HospitalSeoulKorea

Personalised recommendations