Multilevel thoracic ossification of ligamentum flavum coexisted with-without lumbar spinal stenosis: staged surgical strategy and clinical outcomesReport as inadecuate




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BMC Musculoskeletal Disorders

, 16:206

First Online: 19 August 2015Received: 26 March 2015Accepted: 10 August 2015

Abstract

BackgroundThoracic ossification of ligamentum flavum TOLF is a progressively disabling disease. Isolated or continuous TOLF has been frequently reported in literature, however there are very few reports of multilevel or non-continuous TOLF. The purpose of the study was to discuss the surgical strategy of multilevel TOLF and evaluate safety and efficacy of a two-stage operation regimen.

MethodsFrom October 2007 to May 2014, eleven patients 4 males, 7 females that underwent two-stage surgery for multilevel spinal stenosis were retrospectively reviewed. The follow-up period lasted at least 12 months. Demographic data, radiological findings as well as operative data were collected. Postoperative functional outcomes evaluated by the modified Japanese Orthopedic Association score mJOA and complications were analyzed.

ResultsThe patients ranged in age from 30 to 65 years average, 50.2 ± 11.8 years, and comprised 4 men and 7 women. All patients exhibited significant improvements in neurological deficits. The mJOA score improved from a mean of 3.5 ± 2.2 preoperatively to 4.6 ± 2.3 before second-stage surgery and to 7.5 ± 2.2 at final follow-up. The improvement was statistically significant in the average mJOA improvement rate at final follow-up. No staging-related complications were noted in this study.

ConclusionsStaged surgery can effectively achieve neurological functional recovery in patients with multi-segment spinal stenosis in thoracic and lumbar regions, with favorable efficacy and safety. Yet, slight neurological deterioration was observed during the intervals of these two index surgeries.

AbbreviationsTOLFThoracic ossification of ligamentum flavum

mJOAModified Japanese Orthopedic Association score

TSSThoracic spinal stenosis

OLFOssification of ligamentum flavum

CTComputed tomography

MRIMagnetic resonance imaging

LSSLumbar spinal stenosis

MEPMotor evoked potential

SEPSomatosensory evoked potential

IRImprovement rate

BMIBody mass index

DODural ossification

OPLLOssification of the posterior longitudinal ligament

CSFCerebrospinal fluid

ICUIntensive care unit

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Author: Wen-jing Li - Shi-gong Guo - Zhi-jian Sun - Yu Zhao

Source: https://link.springer.com/







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