Abstract
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.
Similar content being viewed by others
References
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 99:157–161
Chang UK, Choe WJ, Chung CK, Kim HJ (2001) Surgical treatment for thoracic spinal stenosis. Spinal Cord 39:362–369
Enomoto H, Kuwayama N, Katsumata T, Doi T (1988) Ossification of the ligamentum flavum. A case report and its MRI finding. Neuroradiology 30:571–573
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 12:250–256
Fong SY, Wong HK (2004) Thoracic myelopathy secondary to ligamentum flavum ossification. Ann Acad Med Singapore 33:340–346
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 34:750–753
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) 31:936–942
Kudo S, Ono M, Russell WJ (1983) Ossification of thoracic ligamenta flava. AJR Am J Roentgenol 141:117–121
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 99:251–256
Nishiura I, Isozumi T, Nishihara K, Handa H, Koyama T (1999) Surgical approach to ossification of the thoracic yellow ligament. Surg Neurol 51:368–372
Parekh HC, Gurusinghe NT, Perera SS, Prabhu SS (1993) Ossification of the ligamentum flavum in a Caucasian: case report. Br J Neurosurg 7:687–690
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 94:221–226
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 100:71–74
Trivedi P, Behari S, Paul L, Banerji D, Jain VK, Chhabra DK (2001) Thoracic myelopathy secondary to ossified ligamentum flavum. Acta Neurochir (Wien) 143:775–782
Vasudevan A, Knuckey NW (2002) Ossification of the ligamentum flavum. J Clin Neurosci 9:311-313
Xiong L, Zeng QY, Jinkins JR (2001) CT and MRI characteristics of ossification of the ligamenta flava in the thoracic spine. Eur Radiol 11:1798–1802
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 14:1121–1125
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 66:511–518
Author information
Authors and Affiliations
Corresponding author
Additional information
A comment to this article can be found at http://dx.doi.org/10.1007/s00586-005-0908-4.
Rights and permissions
About this article
Cite this article
Kuh, S.U., Kim, Y.S., Cho, Y.E. et al. Contributing factors affecting the prognosis surgical outcome for thoracic OLF. Eur Spine J 15, 485–491 (2006). https://doi.org/10.1007/s00586-005-0903-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-005-0903-9