Laminar shelling decompression for treatment of thoracic ossification of ligamentum flavum with spondylotic myelopathy
- VernacularTitle:层揭薄化法减压治疗胸椎黄韧带骨化合并脊髓病
- Author:
Yuan XUE
;
Pei WANG
;
Xinlong MA
- Publication Type:Journal Article
- Keywords:
Ossification, heterotopic;
Ligamentum flavum;
Thoracic vertebrae;
Spinal cord compression;
Decompression, surgical
- From:
Chinese Journal of Orthopaedics
2001;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce laminar shelling decompression technique and to discuss its benefit for decompression of thoracic ossification of ligamentum flavum. Methods 102 patients were diagnosed as thoracic ossification of ligamentum flavum, 63 males and 39 females with an average age of 49.7 years (range, 33 to 71 years). 99 cases suffered with sensation disturbance, 73 cases with constriction on trunk or lower limbs, 77 cases with sphincter dysfunction. The IMSOP Standard Neurological Classification of Spinal Cord Injury was applied for localized the level of thoracic spondylopathy. The JOA lower limb motor function standard and sphincter function standard were used to evaluate the ability of lower limb motion and sphincter function respectively. In the decompression the dorsal cortex of lamina was the first layer to resect, the facet joint surface indicate the depth for removing the second layer, then thinning the ossified tissue by shaving with the motor bur until it was somewhat lucent. Finally decompress the spinal canal by moth eaten manner. Results The mean decompression length was 2.8 lamina(2 to 4 lamina). The mean follow-up duration was 18.9 months (3 to 41 months). Among 99 sensation disturbance 69 totally recovered, 30 relived. 73 cases with the feel of constriction of trunk or lower limbs were completely recovered. Postoperative JOA sphincter function score was 2.632?0.407, comparing with the preoperation score, and the difference was significant (t=15.93, P