Laminar thinned-segmented decompression for treatment of thoracic ossification of ligamentum flavum with myelopathy

郝定均(Hao Dingjun，ept Spine Surg，Xi’an Red Cross Hosp，Xi’an 710054)… ∥Chin J Orthop.－2010，30(11).－1030～1034

Laminar thinned-segmented decompression for treatment of thoracic ossification of ligamentum flavum with myelopathy

郝定均(Hao Dingjun，ept Spine Surg，Xi’an Red Cross Hosp，Xi’an 710054)… ∥Chin J Orthop.－2010，30(11).－1030～1034

ObjectiveTo evaluate the effects of the laminar thinned-segmented decompression technique in the treatment of thoracic ossification of ligamentum flavum with spondylotic myelopathy.MethodsFrom January 1999 toJanuary2009，126 casesundergone the laminar thinned-segmented decompression.There were 73 males and 53 females with an average age of 50.2 years(range from 35 to 71 years).The affected segments located in upper thoracic spine in 28 cases，in mid-thoracic spine in 32 cases and in lower thoracic spine in 66 cases.The postoperative outcomes were evaluated by Epstein and Schwall criteria，postoperative Japanese Orthopaedic Association(JOA)sphincter function score and JOA motor function score.All cases were examined by X-ray，CT and MRI to evaluate bone fusion.ResultsOne hundred and sixteen cases were followed up from 12 to 96 months，with an average of 49.5 months.Post-operative JOA sphincter function score was 2.654 ± 0.413 which had been significantly improved compared with the preoperative score(1.981 ±0.543).Postoperative JOA motor function score was 3.720 ±0.709，which was significantly increased compared with the pre-operative score which was 1.196 ± 0.964.According to Epstein and Schwall criteria，the clinical outcomes were excellent in 73 cases，good in 31 cases，fair in 9 cases and bad in 3 cases，and the excellent and good rate was 89.7%.Postoperative complications included spinal cord injury(6 cases)，leakage of cerebrospinal fluid(5 cases)，and infection of the incision(2 cases).Six months after operation，111 cases has achieved bone fusion，and all cases got bone fusion at the last follow up time.ConclusionThe laminar thinned-segmented decompression technique is preferable to treat thoracic ossification of ligamentum flavum with spondylotic myelopathy.15 refs，2 figs，1 tab.

(Authors)