Posterior decompression with transforaminal interbody fusion for thoracic myelopathy due to ossification of the posterior longitudinal ligament and the ligamentum flavum at the same level

Liu, Fajing; Chai, Yu Shuang; Shen, Yong; Xu, Jiaxin; Du, Wei; Zhang, Peng

doi:10.1016/j.jocn.2012.04.016

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…As the mobility and range of motion of the lower thoracic spine are high, the local stress changes resulted from frequent flexion, extension, and rotation can cause ossification of the ligamentum flavum in this area [1,12]. In this study, 46 ossified segments were distributed in the lower thoracic segments (T9–T12), accounting for 48.4% (46/95) of all ossified segments, which is a finding supported by previous studies[5,8,10].…”

Section: Discussionsupporting

confidence: 90%

“…Cerebrospinal fluid (CSF) leakage following dural incision is one of the major intraoperative complications, occurring especially in cases with dural adhesion and dural ossification [2–7,10,13–19]. There are several ways to deal with cerebrospinal fluid leakage.…”

Section: Discussionmentioning

confidence: 99%

“…The American Spinal Injury Association (ASIA) motor and sensory impairment scale was used to determine the recovery of neurological function [9]. Thoracic kyphosis was evaluated by measuring the Cobb angle [10], which was the angle from the upper end of the previous vertebral body of the segment of the lesion to the lower end of the next vertebral body of the lesion segment.…”

Section: Methodsmentioning

confidence: 99%

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Benefits and Risks of Subsection Laminectomy with Pedicle Screw Fixation for Ossification of the Ligamentum Flavum of the Thoracic Spine: A Retrospective Study of 30 Patients

et al. 2019

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BackgroundThis study aimed to evaluate the effectiveness of subsection laminectomy with pedicle screw fixation (SLPF) for the treatment of ossification of the ligamentum flavum of the thoracic spine.Material/MethodsThirty patients (age, 40–71 years) with ossification of the ligamentum flavum of the thoracic spine underwent SLPF (13 men, 17 women). Operative time, intraoperative blood loss, preoperative and postoperative change in thoracic kyphosis, and perioperative complications were recorded. The Japanese Orthopedic Association (JOA) score for severity of myelopathy and the American Spinal Injury Association (ASIA) motor and sensory impairment scale were used before and after surgery.ResultsMean operative time for SLPF was 208.4±38.3 min and mean intraoperative blood loss was 689.3±171.7 ml. The mean JOA score significantly increased from 5.7±1.9 before surgery to 8.8±2.2 at one month after surgery and 9.3±2.7 at the last follow-up (P<0.01). Postoperative improvement in neurological function increased by 68.3±14.4%. The postoperative ASIA grades significantly improved compared with the preoperative grades (P<0.01). The mean local Cobb angle significantly decreased from 17.8±4.3° before surgery to 15.4±3.6° at one month after surgery and 15.8±3.8° at the last follow-up (P<0.01). Three patients (10%) had operative cerebrospinal fluid (CSF) leak. Postoperatively, one patient had neurological deterioration, two patients had deep venous thrombosis (DVT), and one patient developed a wound infection.ConclusionsSLPF was an effective procedure for the treatment of ossification of the ligamentum flavum of the thoracic spine.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Benefits and Risks of Subsection Laminectomy with Pedicle Screw Fixation for Ossification of the Ligamentum Flavum of the Thoracic Spine: A Retrospective Study of 30 Patients

et al. 2019

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“…This present study found that CD had a significantly higher likelihood of CSFL, accounting for 41.8% of the CD subgroup ( Table 2 ). This proportion was quite high, compared with previous publications on the same procedure [ 17 18 19 ]. This may be due to both pathological and technical reasons.…”

Section: Discussionmentioning

confidence: 53%

Cerebrospinal Fluid Leakage after Surgeries on the Thoracic Spine: A Review of 362 Cases

Liu

et al. 2016

Asian Spine J

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Study DesignA retrospective clinical review.PurposeTo describe the incidence of cerebrospinal fluid leakage (CSFL) after thoracic decompression and examine the CSFL predisposing clinical factors.Overview of LiteratureCSFL is a common complication following thoracic decompression but has not been sufficiently addressed in former studies.MethodsA cohort of 362 cases of thoracic decompression from February of 2005 to June of 2013 was examined. The case medical records were reviewed and the occurrence of CSFL and the related clinical parameters were noted. The incidence of CSFL for the entire cohort and each surgical approach were described. Besides, the relationship between CSFL and other clinical parameters were assessed, of which odds ratio values of all CSFL-associated parameters were calculated using multivariate logistic regression analysis.ResultsThe incidence of CSFL for the entire cohort was 32.3%. Different surgical approaches had different incidences of CSFL, and circumferential decompression had the highest incidence. Though many different clinical parameters were related to the occurrences of CSFL, being older than 52 years, having ossification of the posterior longitudinal ligament or having longer operative segments than 3 vertebrae were significant risk factors for CSFL (p<0.05). Besides, surgeries on the mid-thoracic spine had an increased risk of CSFL (p<0.05).ConclusionsFrom our analysis, CSFL was a common complication after thoracic decompression with the incidence of up to 32.3%. This study identified the predisposing clinical factors, and spinal surgeons should be aware of these risk factors to reduce its incidence.

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“…TTIF can be a useful option for decompressive and reconstructive surgery of the mid and lower thoracic spine. [7,8] In short, the TTIF approach can be a safe and useful method for providing interbody fusion and reconstructing the thoracic spine. As for thoracic degenerative spondylolisthesis, posterior decompression with posterolateral fusion or TTIF were the main treatment modalities, however, TTIF has its unique advantages because of sufficient decompression, immediate stability and high fusion rate.…”

Section: Discussionmentioning

confidence: 99%

Thoracic degenerative spondylolisthesis-associated myelopathy

Wang¹,

Lin²,

Liang³

et al. 2021

Medicine

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Rationale:The thoracic spine is stabilized in the anteroposterior direction by the rib cage and the facet joints, thus thoracic degenerative spondylolisthesis is very uncommon. Here, we report a rare case of thoracic degenerative spondylolisthesis in which the lower thoracic region was the only region involved.Patient concerns:We present the case of a 56-year-old Chinese female who suffered from thoracic degenerative spondylolisthesis. She had a 2-year history of gait disturbance and bilateral lower-extremity numbness. The initial imaging examinations revealed Grade I anterior spondylolisthesis and severe cord compression, as well as bilateral facet joint osteoarthritis at T11/12.Diagnosis:The patient was diagnosed with thoracic degenerative spondylolisthesis-associated myelopathy.Interventions:She underwent a posterior decompression with transforaminal thoracic interbody fusion (TTIF) at T11/12.Outcomes:The patient recovered well after the operation, and MRI at 12-month follow-up revealed that spinal cord compression was relieved and high signal intensity in T2-weighted image was improved.Lessons:To the best of our knowledge, this is the first reported case of thoracic degenerative spondylolisthesis in which the lower thoracic region was the only region involved. Disruption of joint capsule, instability with micromotion, and degenerative disc may contribute to this rare disease. Posterior decompression with posterolateral fusion or TTIF were the main treatment modalities, however, TTIF has its unique advantages because of sufficient decompression, immediate stability and high fusion rate.

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Posterior decompression with transforaminal interbody fusion for thoracic myelopathy due to ossification of the posterior longitudinal ligament and the ligamentum flavum at the same level

Cited by 10 publications

References 23 publications

Benefits and Risks of Subsection Laminectomy with Pedicle Screw Fixation for Ossification of the Ligamentum Flavum of the Thoracic Spine: A Retrospective Study of 30 Patients

Benefits and Risks of Subsection Laminectomy with Pedicle Screw Fixation for Ossification of the Ligamentum Flavum of the Thoracic Spine: A Retrospective Study of 30 Patients

Cerebrospinal Fluid Leakage after Surgeries on the Thoracic Spine: A Review of 362 Cases

Thoracic degenerative spondylolisthesis-associated myelopathy

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