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学科主题: 临床医学
题名:
Circumferential decompression via the posterior approach for the surgical treatment of multilevel thoracic ossification of the posterior longitudinal ligaments: a single institution comparative study
作者: Liu Xiao; Zhu Bin; Liu Xiaoguang; Liu Zhongjun; Dang Gengting
关键词: ossification of the posterior longitudinal ligament ; multilevel ; thoracic spinal stenosis ; intraoperative ultrasonography
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2014-10-05
DOI: 10.3760/cma.j.issn.0366-6999.20140557
卷: 127, 期:19, 页:3371-3377
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: SPINAL-CORD DECOMPRESSION ; ANTERIOR DECOMPRESSION ; CIRCUMSPINAL DECOMPRESSION ; TECHNICAL NOTE ; MYELOPATHY ; FUSION ; FLAVUM
英文摘要:

Background The treatment strategies for multilevel thoracic ossification of the posterior longitudinal ligaments (T-OPLL) were rarely reported. The aim of this study was to investigate the clinical outcomes and complications of circumferential decompression for multilevel T-OPLL and compare two different methods in the management of the OPLL (resection or floating).

Methods Data of sequentially treated patients who received surgical treatment for thoracic spinal stenosis caused by multilevel T-OPLL from January 2005 to February 2012 were retrospectively reviewed. Based on the surgical approaches applied, the patients were divided into two groups. Group A consisted the patients who received posterior decompression and group B consisted the patients who received circumferential decompression via the posterior approach. Group B was further divided into two subgroups: subgroup 1 (the resection group) where the OPLL was completely resected and subgroup 2 (the floating group) where the OPLL was floated.

Results A total of 49 patients were included in the study. Fourteen patients with single posterior decompression were included in group A and 35 patients who received circumferential decompression were included in group B. In group B, 29 patients had complete resection of the ossified posterior longitudinal ligaments, while the other six underwent a flotation procedure. The follow-up data were available in 39 patients. Mean JOA scores improved from 5.4 +/- 1.8 to 7.5 +/- 2.8 in group A and from 3.7 +/- 1.8 to 7.9 +/- 2.4 in group B. The main complications included cerebrospinal fluid (CSF) leakage and postoperative neurologic deterioration (ND). Twenty-three of the 25 cases with postoperative CSF leakage achieved a complete recovery at the last follow-up and 12 of the 15 cases with ND achieved some neurological improvement at the last follow-up.

Conclusions Circumferential decompression via the posterior approach is an effective surgical method for thoracic spinal stenosis caused by multilevel OPLL of the thoracic spine. Patients who receive complete resection of the ossified posterior longitudinal ligaments may have better recovery rate than the "floating" group.

语种: 英语
所属项目编号: 81472041 ; Z141107002514011
项目资助者: National Natural Science Foundation of China ; Beijing Municipal Science and Technology Commission
WOS记录号: WOS:000344724000003
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/67650
Appears in Collections:北京大学第三临床医学院_骨科_期刊论文

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作者单位: Peking Univ, Dept Orthopaed, Hosp 3, Beijing 100191, Peoples R China

Recommended Citation:
Liu Xiao,Zhu Bin,Liu Xiaoguang,et al. Circumferential decompression via the posterior approach for the surgical treatment of multilevel thoracic ossification of the posterior longitudinal ligaments: a single institution comparative study[J]. CHINESE MEDICAL JOURNAL,2014,127(19):3371-3377.
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