[Longterm outcome after the decompressive surgery for thoracic myelopathy due to the ossification of the ligamentum flavum].
Zhonghua Wai Ke Za Zhi
; 50(5): 426-9, 2012 May.
Article
en Zh
| MEDLINE
| ID: mdl-22883949
ABSTRACT
OBJECTIVES:
To investigate the long-term surgical outcome of thoracic myelopathy caused by the ossification of the ligamentum flavum (OLF) and evaluate the related risk factors.METHODS:
Forty-four patients who underwent decompressive laminectomy with thoracic OLF between January 1990 and December 2005 and got more than 5 years follow-up were retrospectively reviewed. Among these 44 cases, there were 29 male and 15 female whose ages at operation were 52 years averagely (27-68 years). The 2-year follow-up results and long-term outcomes were classified according to the modified Epstein's standard, and then the rates of excellent or good (REG) were calculated. The correlation between the long-term REG and the patients' ages, durations of symptoms, decompressed levels, and dural leak were analyzed.RESULTS:
The mean follow-up period of these 44 cases was 8.5 years (5-19 years). The REG at 2 years after laminectomy was 77.3% (34/44), while the long-term REG was 65.9% (29/44). There was one case who had suffered from an acute spinal cord injury got a poor post-operative outcome. The other 43 cases had chronic durations, including 22 cases whose pre-operative durations of symptoms were less than 12 months and 21 cases whose durations were equal to or more than 12 months. And the long-term REG of these two groups were 77.3% (17/22) and 57.1% (12/21) respectively (P>0.05). The REG of those cases whose decompression levels were limited in T1-T9 was 78.9% (15/19), while that of those cases whose laminectomy was relevant to thoracolumbar segment (T10-L2) was 58.3% (14/24) (P>0.05). There were 7 cases who had excellent or good short-term results and poor long-term outcomes. The reasons of these changes included coexistence of lumbar spinal stenosis in three cases and the growth of the OLF at the adjacent levels in four cases.CONCLUSIONS:
Although the short-term results of the decompressive surgery for thoracic OLF is good, the regular long-term follow-up is necessary because the symptoms may reoccur or deteriorate secondary to lumbar spinal stenosis or the growth of OLF at the adjacent levels near former decompressive levels; the duration of symptoms which is more than one year and the decompression levels that is involved to T10-L2 segments are possibly related to the poor long-term outcomes.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vértebras Torácicas
/
Osificación Heterotópica
/
Ligamento Amarillo
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Zh
Revista:
Zhonghua Wai Ke Za Zhi
Año:
2012
Tipo del documento:
Article
País de afiliación:
China