Surgical outcomes of the thoracic ossification of ligamentum flavum: a retrospective analysis of 61 cases
| العنوان: | Surgical outcomes of the thoracic ossification of ligamentum flavum: a retrospective analysis of 61 cases |
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| المؤلفون: | Kazuyuki Otani, Toshitaka Yoshii, Osamu Nakai, Shigeo Shindo, Yoshiyasu Arai, Tsuyoshi Yamada, Kazuo Kusano, Norihiko Miyake, Atsushi Okawa, Shuta Ushio |
| المصدر: | BMC Musculoskeletal Disorders BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-11 (2021) |
| بيانات النشر: | BioMed Central, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Sports medicine, Lumbar spinal canal stenosis, Thoracic Vertebrae, Lesion, 03 medical and health sciences, 0302 clinical medicine, Lumbar, Ossification of the ligamentum flavum, Spine surgery, Rheumatology, Osteogenesis, Internal medicine, Epidemiology, medicine, Humans, Orthopedics and Sports Medicine, Aged, Retrospective Studies, 030222 orthopedics, integumentary system, Ossification, business.industry, Ossification, Heterotopic, Tandem spinal stenosis, Decompression, Surgical, Surgery, Thoracic myelopathy, Ligamentum Flavum, Treatment Outcome, Orthopedic surgery, lcsh:RC925-935, medicine.symptom, business, 030217 neurology & neurosurgery, Research Article |
| الوصف: | Background Thoracic ossification of ligamentum flavum (T-OLF), as one of the causes of thoracic myelopathy, is often combined with other spinal disorders. Concurrent lumbar spinal canal stenosis (LCS) is often obscured by symptoms due to T-OLF, leading to difficulty in identifying the origin of these neurological findings. It is common to be misdiagnosed or delayed diagnosis due to the complicated nature. We evaluated the prevalence, distribution, and clinical characteristics of OLF, especially in patients with LCS. Methods The authors performed a retrospective analysis of the outcomes of 61 patients who underwent thoracic surgeries performed for symptomatic T-OLF. In all the patients, whole spine lesions were evaluated preoperatively. We examined the factors related to poor outcomes (the recovery rate of the Japanese Orthopedic Association score for thoracic myelopathy is less than 40%) following OLF surgeries. We compared the clinical outcomes according to whether there was concurrent LCS, and determined the optimal surgical approach. Results The occurrence of T-OLF increased with age. Forty-six cases (75.4%) were considered to be tandem T-OLF and LCS (LCS group). An advanced age, and concurrent LCS were associated with a poor outcome after the surgery. The LCS group significantly included a greater number of elderly, and more light-weighted patients with Modic change in thoracic spine and a greater sagittal vertical axis, resulting in the lower neurological recovery. Additional lumbar surgery (13cases) effectively improved both the T-JOA and L-JOA scores (from 6.5 ± 2.0 points to 8.0 ± 1.8 points, p = 0.0406, and from 14.5 ± 4.7 points to 20.7 ± 2.6 points, p = 0.001, respectively) in OLF patients with LCS. Conclusions T-OLF was highly associated with other spinal disorders. Poor outcomes in T-OLF surgery could be associated with age and concurrent LCS, and an additional surgery for another lumbar lesion significantly improved neurological findings in T-OLF patients. |
| اللغة: | English |
| تدمد: | 1471-2474 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::59c03a3a601c648088248073bed8fd3bTest http://europepmc.org/articles/PMC7784257Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....59c03a3a601c648088248073bed8fd3b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712474 |
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