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23 August 2019 : Clinical Research  

Benefits and Risks of Subsection Laminectomy with Pedicle Screw Fixation for Ossification of the Ligamentum Flavum of the Thoracic Spine: A Retrospective Study of 30 Patients

Yong Wang1ABEF, Liu Yang1CD, Tao Lei1DEF, Yong-Sheng Lin1BD, Xiang-Bei Qi1BCDEF, Zhi-Hong Wang1BCE, Jun-Ming Cao1AG*

DOI: 10.12659/MSM.915318

Med Sci Monit 2019; 25:6341-6350

Abstract

BACKGROUND: This study aimed to evaluate the effectiveness of subsection laminectomy with pedicle screw fixation (SLPF) for the treatment of ossification of the ligamentum flavum of the thoracic spine.

MATERIAL AND METHODS: Thirty patients (age, 40–71 years) with ossification of the ligamentum flavum of the thoracic spine underwent SLPF (13 men, 17 women). Operative time, intraoperative blood loss, preoperative and postoperative change in thoracic kyphosis, and perioperative complications were recorded. The Japanese Orthopedic Association (JOA) score for severity of myelopathy and the American Spinal Injury Association (ASIA) motor and sensory impairment scale were used before and after surgery.

RESULTS: Mean operative time for SLPF was 208.4±38.3 min and mean intraoperative blood loss was 689.3±171.7 ml. The mean JOA score significantly increased from 5.7±1.9 before surgery to 8.8±2.2 at one month after surgery and 9.3±2.7 at the last follow-up (P<0.01). Postoperative improvement in neurological function increased by 68.3±14.4%. The postoperative ASIA grades significantly improved compared with the preoperative grades (P<0.01). The mean local Cobb angle significantly decreased from 17.8±4.3° before surgery to 15.4±3.6° at one month after surgery and 15.8±3.8° at the last follow-up (P<0.01). Three patients (10%) had operative cerebrospinal fluid (CSF) leak. Postoperatively, one patient had neurological deterioration, two patients had deep venous thrombosis (DVT), and one patient developed a wound infection.

CONCLUSIONS: SLPF was an effective procedure for the treatment of ossification of the ligamentum flavum of the thoracic spine.

Keywords: Internal Fixators, Ossification of Posterior Longitudinal Ligament, Thoracic Surgery, Decompression, Surgical, Laminectomy, Ligamentum Flavum, Ossification, Heterotopic, Osteogenesis, Pedicle Screws, Postoperative Period, Risk Assessment, Thoracic Vertebrae

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750