Full-endoscopic decompression for thoracic myelopathy caused by ossification of the ligamentum flavum: patient series

Kotheeranurak, Vit; Pholprajug, Phattareeya; Lin, Guang‐Xun; Pruttikul, Pritsanai; Yingsakmongkol, Wicharn; Tejapongvorachai, Tawechai; Kim, Jin-Sung

doi:10.3171/case20138

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…In total, 23 relevant studies were included in this analysis, 10–32 enrolling 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Ye,

Guo,

et al. 2023

Spine

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Study Design. Systematic review and meta-analysis. Objective. This study systematically reviewed and evaluated the safety and efficacy of spinal endoscopic techniques as a treatment for thoracic ligamentum flavum ossification (TOLF). Summary of Background Data. The use of spinal endoscopic techniques for the treatment of TOLF has increased in recent years. The present study is the first comprehensive systematic review and meta-analysis focused on the use of spinal endoscopic techniques for TOLF. Methods. The Cochrane Central, PubMed, Web of Science, and Embase databases were systematically searched for studies focused on patients undergoing spinal endoscopic techniques to treat symptomatic TOLF. Results. This meta-analysis included 23 studies. We included 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years, with 304 total recorded lesion locations of which 245 were located in the lower thoracic spine. Complications affected 35/323 patients, and the mean operative duration for 305 patients was 108.15±47.34 minutes. For 187 patients, the mean operative bleeding was 25.13±12.54 mL, while for 87 patients the mean duration of hospitalization was 4.59±1.93 days. At last follow-up，functional assessment was performed for 260 patients, of whom 200 were in excellent condition, visual analog scale (VAS) scores were assessed for 160 patients, with a mean improvement of 4.40 (3.95,4.86) Japanese Orthopedic Association (JOA) scores were recorded for 115 patients, with a mean improvement of 2.99 (2.77,3.22) , and modified Japanese Orthopedic Association (mJOA) scores were recorded for 208 patients, with a mean improvement of 3.41 (3.17,3.64) . Conclusions. These results support several advantages of spinal endoscopic techniques for the treatment of symptomatic TOLF. These include low complication rates, rapid postoperative recovery, and good functional recovery when used for single-segment, non-nodular ossification and no combined dural ossification.

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“…In total, 23 relevant studies were included in this analysis, 10–32 enrolling 323 patients (177 males, 146 females) with a mean age of 58.40±10.06 years (Fig. 2).…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Ye,

Guo,

et al. 2023

Spine

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“…The technique of unilateral laminotomy for bilateral decompression (ULBD) helps decompress the thoracic cord safely. 42,43 Intraoperative localization is a critical issue while conducting thoracic spine surgeries. C-arm fluoroscopy is the most common modality to localize the index level during operation.…”

Section: Indications Of Ess For Thoracic Spinementioning

confidence: 99%

Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

et al. 2023

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Endoscopic spine surgery (ESS) has evolved as a safe, effective, and efficient alternative for minimally invasive spine surgery (MISS). The innovation of full-endoscopic systems makes definitive decompression surgery through different approaches feasible. The approach can be determined according to the location of the target lesion or the surgeon's preference. During the past 2 decades, ESS has expanded its indications from lumbar to cervical spines. Except for decompression, endoscopy-assisted fusion surgery is also developing. However, ESS is still evolving and has a steep learning curve. The revolution of technologies and ESS techniques will enable surgeons to treat various spinal diseases more practically. In recent years, the application of the computer-assisted navigation system and augmented reality have reformed imaging quality and interpretation. The endoscopic rhizotomy techniques have opened a new way for MISS of chronic low back pain. This review introduces the current indications of ESS and its potential future expansion.

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“…Ossification of the ligamentum flavum (OLF) is an ossification disease of the spinal ligaments, commonly found in East Asia. 1 , 2 Thoracic ossification of the ligamentum flavum (TOLF) mainly involves the lower thoracic spine, leading to thoracic spinal stenosis and thoracic spinal cord compression, 3 , 4 , 5 , 6 which seriously affect patient quality of life. At present, surgery is the main treatment for TOLF.…”

Section: Introductionmentioning

confidence: 99%

M1 macrophage‐derived oncostatin M induces osteogenic differentiation of ligamentum flavum cells through the JAK2/STAT3 pathway

Yang,

Chen,

Fan

et al. 2023

JOR Spine

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BackgroundM1 macrophages (Mφs) are involved in osteogenic differentiation of ligamentum flavum (LF) cells and play an important role in heterotopic ossification. However, the mechanism by which M1 Mφs influence osteogenic differentiation of LF cells has not been studied.MethodsThe effect of conditioned medium including secretions of M1 Mφs (CM‐M1) on LF cells was analyzed by GeneChip profiling and ingenuity pathway analysis (IPA). THP‐1 cells were polarized into M1 Mφs and CM‐M1 was used to induce LF cells. In addition, LF cells were induced by CM‐M1 in the presence of cyclooxygenase 2 (COX‐2) inhibitors or oncostatin M (OSM)‐neutralizing antibodies. Based on the presence of OSM, knockout of OSMR or GP130 receptors, or addition of the Janus kinase 2 (JAK2) inhibitor AZD1480 or signal transducer and activator of transcription 3 (STAT3) inhibitor Stattic were examined for effects on osteogenic differentiation of LF cells. OSM secretion was quantified by ELISA, while qPCR and western blot were used to evaluate expression of osteogenic genes and receptor and signaling pathway‐related proteins, respectively.ResultsGeneChip and IPA results indicate that the OSM signaling pathway and its downstream signaling molecules JAK2 and STAT3 are significantly activated. ELISA results indicate that OSM is highly expressed in cells treated with CM‐M1 and lowly expressed in cells treated with CM‐M1 and a COX‐2 inhibitor. Besides, CM‐M1 induces osteogenic differentiation of LF cells, which is weakened when COX‐2 inhibitors or OSM‐neutralizing antibody are added to it. Recombinant OSM could induce osteogenic differentiation of LF cells and upregulate expression of OSMR, GP130, phosphorylated (P)‐JAK2, and P‐STAT3. Upon knockdown of OSMR or GP130, or the addition of AZD1480 or Stattic, P‐JAK2 and P‐STAT3 expression were decreased and osteogenic differentiation was reduced.ConclusionM1 Mφ‐derived OSM induces osteogenic differentiation of LF cells and the JAK2/STAT3 signaling pathway plays an important role.

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Full-endoscopic decompression for thoracic myelopathy caused by ossification of the ligamentum flavum: patient series

Cited by 6 publications

References 13 publications

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Safety and Efficacy Outcomes Following Spinal Endoscopic Procedures for Thoracic Ligamentous Ossification

Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

M1 macrophage‐derived oncostatin M induces osteogenic differentiation of ligamentum flavum cells through the JAK2/STAT3 pathway

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