Surgical Results of Patients with Myelopathy due to Ossification of the Ligamentum Flavum with Ossification of the Posterior Longitudinal Ligament or a Vertebral Fracture at the Same Level of the Thoracic Spine: A Retrospective Comparative Study

Yuji Kasukawa; Naohisa Miyakoshi; Michio Hongo; Yoshinori Ishikawa; Daisuke Kudo; Ryota Kimura; Yuichi Ono; Jumpei Iida; Chiaki Sato; Yoichi Shimada

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저자정보: Yuji Kasukawa (Akita University Graduate School of Medicine) Naohisa Miyakoshi (Akita University Graduate School of Medicine) Michio Hongo (Akita University Graduate School of Medicine) Yoshinori Ishikawa (Akita University Graduate School of Medicine) Daisuke Kudo (Akita University Graduate School of Medicine) Ryota Kimura (Akita University Graduate School of Medicine) Yuichi Ono (Akita University Graduate School of Medicine) Jumpei Iida (Akita University Graduate School of Medicine) Chiaki Sato (Akita University Graduate School of Medicine) Yoichi Shimada (Akita University Graduate School of Medicine)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.13 No.5

발행연도: 2019.1

수록면: 832 - 841 (10page)

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Study Design: Retrospective and comparative study. Purpose: We assessed surgical treatment outcomes in patients with thoracic myelopathy due to ossification of the ligamentum flavum (OLF), and OLF combined with ossification of the posterior longitudinal ligament (OPLL) or vertebral fracture (VF) at the same level. Overview of Literature: OLF and OPLL cause severe thoracic myelopathy. Osteoporotic VF commonly occurs at the thoracolumbar junction. There have been no investigations of thoracic myelopathy due to OLF and VF. Methods: Forty patients were divided among three groups: the OLF group (n=23): myelopathy due to OLF, the OLF+OPLL group (n=12): myelopathy due to OLF and OPLL, and the OLF+VF group (n=5): myelopathy due to OLF and VF. We recorded OLF, OPLL, and VF sites and operative procedures. Each patient’s neurological status, according to the Japanese Orthopaedic Association (JOA) score, and walking ability were evaluated pre- and postoperatively. Results: Patients in the OLF+OPLL group were significantly younger than those in the other two groups. The preoperative JOA score was significantly lower in the OLF+VF than OLF group. The final JOA score was significantly lower in the OLF+VF than OLF and OLF+OPLL groups. The JOA score recovery rate was significantly lower in the OLF+VF than OLF group. Final walking ability was significantly worse in the OLF+OPLL and OLF+VF groups than in the OLF group and significantly worse in the OLF+VF than OLF+OPLL group. Conclusions: Thoracic myelopathy due to OLF+VF occurs primarily in older females, who also exhibit worse preoperative and postoperative neurological status, and worse walking ability, than patients with thoracic myelopathy due to OLF or OLF+OPLL.

#Ligamentum flavum ossification #Posterior longitudinal ligament ossification #Osteoporotic fracture #Compression fracture #Myelopathy

참고문헌 (25)

참고문헌 신청

Mori K / 2013 / Prevalence, distribution, and morphology of thoracic ossification of the yellow ligament in Japanese : results of CTbased cross-sectional study / Spine(Phila Pa 1976) 38:E1216~E1222

Aizawa T / 2007 / Results of surgical treatment for thoracic myelopathy : minimum 2-year follow-up study in 132 patients / J Neurosurg Spine 7:13~20

Sato T / 2009 / Current status of thoracic myelopathy / Sekitsui Sekizui(Spine Spinal Cord) 22:136~141

Hirabayashi S / 2017 / Ossification of the ligamentum flavum / Spine Surg Relat Res 1:158~163

Hongo M / 2012 / Association of spinal curve deformity and back extensor strength in elderly women with osteoporosis in Japan and the United States / Osteoporos Int 23:1029~1034

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