Surgical outcomes of percutaneous endoscopic thoracic decompression in the treatment of multi-segment thoracic ossification of the ligamentum flavum

Liu, Yunxuan; Li, Xingchen; Hou, Yingying; Leng, Xiangyang; Yan, Ming; Chen, Xiaoxin; Huang, Honghan; Xu, Yangsheng

doi:10.1007/s00701-023-05603-9

Cited by 4 publications

(2 citation statements)

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“…Heterogeneity among studies complicated analyses of operative duration, operative bleeding, and hospitalization duration in this study owing to variability among operators, patients, and procedural details. With respect to operative duration, patients with multisegmental ossification were excluded, 30 as the operative duration for the treatment of multisegmental OLF is significantly longer than that for single-segment procedures. While substantial heterogeneity was noted with respect to operative duration owing to variations in equipment availability and operator experience, these results highlight the potential of spinal endoscopic techniques to reduce the required operative duration.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, based on the current state of development of endoscopic surgical equipment and techniques, this procedure is only recommended in cases of one to two segmental TOLF, whereas open surgery or multiple staged endoscopic procedures are recommended in cases of multi-segmental TOLF. 30 , 31 Endoscopic treatment is also poorly suited to the management of nodal subtype TOLF, as these patients generally require more extensive decompression and face higher rates of dural tears. 14 …”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%