Risk Factors for Poor Outcomes of Thoracic Ossification of Ligamentum Flavum After Laminectomy

Sun, Jing; Du, Peiyu; Shen, Yong

doi:10.12659/msm.935711

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Previous retrospective studies on postoperative neurological recovery in TOLF patients have rarely been analyzed concerning follow‐up time 18,24 . Similarly, few studies have focused on the long‐term QoL of TOLF patients after surgery; in a study of long‐term QoL after posterior decompression via an uni‐or bilateral approach in patients with degenerative thoracic spinal stenosis, Siller et al 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous retrospective studies on postoperative neurological recovery in TOLF patients have rarely been analyzed concerning follow-up time. 18,24 Similarly, few studies have focused on the long-term QoL of TOLF patients after surgery; in a study of long-term QoL after posterior decompression via an uni-or bilateral approach in patients with degenerative thoracic spinal stenosis, Siller et al 25 reported that 645 patients with surgery for degenerative spondylotic myelopathy within 6 years were followed up for an average of 35.1 months and did not suggest that differences in length of follow-up were significantly correlated with QoL. Our study showed that, grouped by a mean follow-up time of 70.8 months, the difference between the relatively longer and relatively shorter follow-up groups was not statistically significant on the EQ-5D-5L value set, and a difference was found only on the EQ-VAS.…”

Section: Follow-up Timementioning

confidence: 99%

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The Quality of Life of the Patients with Thoracic Ossification of the Ligamentum Flavum after Surgery Using EQ‐5D‐5L

Li,

Deng,

Wang

et al. 2023

Orthopaedic Surgery

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ObjectiveThere is a lack of studies on the quality of life (QoL) after posterior laminectomy in patients with thoracic ossification of the ligamentum flavum (TOLF), and risk factors associated with poor prognosis remain controversial. Therefore, the present study was conducted to illustrate the QoL for TOLF patients after surgery and determine its relationship with their demographic, surgery‐related, clinical characteristics and imaging data.MethodsOne hundred and eighteen patients diagnosed with thoracic myelopathy because of TOLF were enrolled in this retrospective study. They all underwent posterior decompressive laminectomy from August 2010 to January 2022. The QoL was evaluated based on the EQ‐5D‐5L. Collecting gender, age, number of operations, compressed segments, Frankel grade, complications, body mass index (BMI), symptoms and duration, modified Japanese Orthopaedic Association (mJOA) score (preoperative), follow‐up time and type of ossification, increased signal on Sagittal T2‐weighted Images (ISST2I), occupancy rate and analyzing by Mann–Whitney U‐test, Kruskal–Wallis test, the χ2‐test, and logistic regression tests.ResultsAverage follow‐up 70.8 months (18–149), the mean age was 59.74 ± 9.81 years and the mean score for the QoL based on the EQ‐5D‐5 L and visual analogue scale (VAS) score were 0.71 ± 0.28 and 78.88 ± 10.21 at the final follow‐up. Moderate and severe problems were found in the pain/discomfort in 22.0% of the patients. These mobility and usual activities numbers were slightly higher (24.6% and 30.4%, respectively). The mean scores for QoL and VAS were significantly higher in patients with mild and moderate neurological impairment, normal BMI, <60 years of age, no dural tears, symptom relief at hospital discharge, unilateral and bilateral ossification on axial CT scan, ≤ 50% spinal canal occupancy on CT and MRI, and none or fuzzy on ISST2I.ConclusionQoL after posterior laminectomy in TOLF patients is generally satisfactory compared to preoperative levels. Preoperative mJOA score, Age, comorbid diabetes, the major symptom is activity limitation, BMI, ISST2I, Intraoperative dural tears and spinal canal occupancy rate correlate significantly with the corresponding dimensions and are predictive. Age, spinal canal occupancy rate, ISST2I, preoperative mJOA score, BMI are significantly associated with and have predictive value for overall postoperative QoL.

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Section: Discussionmentioning

confidence: 99%

Section: Follow-up Timementioning

confidence: 99%

The Quality of Life of the Patients with Thoracic Ossification of the Ligamentum Flavum after Surgery Using EQ‐5D‐5L

Li,

Deng,

Wang

et al. 2023

Orthopaedic Surgery

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Perioperative complications and cost of posterior decompression with fusion in thoracic spine for ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum -a comparative study using a national inpatient database

Morishita,

Yoshii,

Inose

et al. 2024

BMC Musculoskelet Disord

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Background Although posterior decompression with fusion (PDF) are effective for treating thoracic myelopathy, surgical treatment has a high risk of various complications. There is currently no information available on the perioperative complications in thoracic ossification of the longitudinal ligament (T-OPLL) and thoracic ossification of the ligamentum flavum (T-OLF). We evaluate the perioperative complication rate and cost between T-OPLL and T-OLF for patients underwent PDF. Methods Patients undergoing PDF for T-OPLL and T-OLF from 2012 to 2018 were detected in Japanese nationwide inpatient database. One-to-one propensity score matching between T-OPLL and T-OLF was performed based on patient characteristics and preoperative comorbidities. We examined systemic and local complication rate, reoperation rate, length of hospital stays, costs, discharge destination, and mortality after matching. Results In a total of 2,660 patients, 828 pairs of T-OPLL and T-OLF patients were included after matching. The incidence of systemic complications did not differ significantly between the T-OPLL and OLF groups. However, local complications were more frequently occurred in T-OPLL than in T-OLF groups (11.4% vs. 7.7% P = 0.012). Transfusion rates was also significantly higher in the T-OPLL group (14.1% vs. 9.4%, P = 0.003). T-OPLL group had longer hospital stay (42.2 days vs. 36.2 days, P = 0.004) and higher medical costs (USD 32,805 vs. USD 25,134, P < 0.001). In both T-OPLL and T-OLF, the occurrence of perioperative complications led to longer hospital stay and higher medical costs. While fewer patients in T-OPLL were discharged home (51.6% vs. 65.1%, P < 0.001), patients were transferred to other hospitals more frequently (47.5% vs. 33.5%, P = 0.001). Conclusion This research identified the perioperative complications of T-OPLL and T-OLF in PDF using a large national database, which revealed that the incidence of local complications was higher in the T-OPLL patients. Perioperative complications resulted in longer hospital stays and higher medical costs.

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Risk Factors for Poor Outcomes of Thoracic Ossification of Ligamentum Flavum After Laminectomy

Cited by 2 publications

References 29 publications

The Quality of Life of the Patients with Thoracic Ossification of the Ligamentum Flavum after Surgery Using EQ‐5D‐5L

The Quality of Life of the Patients with Thoracic Ossification of the Ligamentum Flavum after Surgery Using EQ‐5D‐5L

Perioperative complications and cost of posterior decompression with fusion in thoracic spine for ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum -a comparative study using a national inpatient database

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