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Circumferential decompression via the posterior approach for the surgical treatment of multilevel thoracic ossification of the posterior longitudinal ligaments: a single institution comparative study
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
2014-10-05
DOI10.3760/cma.j.issn.0366-6999.20140557
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
WOS记录号WOS:000344724000003
项目编号81472041 ; Z141107002514011
资助机构National Natural Science Foundation of China ; Beijing Municipal Science and Technology Commission
引用统计
被引频次:4[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/67650
专题北京大学第三临床医学院_骨科
作者单位Peking Univ, Dept Orthopaed, Hosp 3, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
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.
APA Liu Xiao,Zhu Bin,Liu Xiaoguang,Liu Zhongjun,&Dang Gengting.(2014).Circumferential decompression via the posterior approach for the surgical treatment of multilevel thoracic ossification of the posterior longitudinal ligaments: a single institution comparative study.CHINESE MEDICAL JOURNAL,127(19),3371-3377.
MLA Liu Xiao,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".CHINESE MEDICAL JOURNAL 127.19(2014):3371-3377.
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