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Microendoscopic posterior decompression for the treatment of thoracic myelopathy caused by ossification of the ligamentum flavum: a technical report.
- Source :
-
European Spine Journal . Jun2016, Vol. 25 Issue 6, p1912-1919. 8p. - Publication Year :
- 2016
-
Abstract
- <bold>Purpose: </bold>Ossification of the ligamentum flavum (OLF) is a common cause of progressive thoracic myelopathy in East Asia. Good surgical results are expected for patients who already show myelopathy. Surgical decompression using a posterior approach is commonly used to treat OLF. This study investigated the use of microendoscopic posterior decompression for the treatment of thoracic OLF.<bold>Methods: </bold>Microendoscopic posterior decompression was performed on 9 patients with myelopathy. Patients had a mean age of 59.8 years and single-level involvement, mostly at the T10-11 and T11-12 vertebrae. Computed tomography and magnetic resonance imaging were used to classify the OLF. A tubular retractor and endoscopic system were used for microendoscopic posterior decompression. Midline and unilateral paramedian approaches were performed in 2 and 7 patients, respectively. Intraoperative motor evoked potentials (MEPs) of 7 patients were monitored. Pre- and postoperative neurological status was evaluated using the modified Japanese Orthopaedic Association (mJOA) score.<bold>Results: </bold>Thoracic OLF for all patients were classed as bilateral type with a round morphology. Improvement of MEPs at least one muscle area was recorded in all patients following posterior decompression. A dural tear in one patient was the only observed complication. The mean recovery rate was 44.9 %, as calculated from mJOA scores at a mean follow-up period of 20 months.<bold>Conclusions: </bold>Microendoscopic posterior decompression combined with MEP monitoring can be used to treat patients with thoracic OLF. The optimal surgical indication is OLF at a single vertebral level and of a unilateral or bilateral nature, without comma and tram track signs, and a round morphology. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09406719
- Volume :
- 25
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- European Spine Journal
- Publication Type :
- Academic Journal
- Accession number :
- 115775197
- Full Text :
- https://doi.org/10.1007/s00586-015-4158-9