Comparative Clinical and Radiographic Cohort Study: Uniportal Thoracic Endoscopic Laminotomy With Bilateral Decompression by Using the 1-Block Resection Technique and Thoracic Open Laminotomy With Bilateral Decompression for Thoracic Ossified Ligamentum Flavum

被引：9

作者：

Kim, Hyeun Sung ^{[1
]}

Wu, Pang Hung ^{[1
,2
]}

Kim, Ji-Yeon ^{[1
]}

Lee, Yeon Jin ^{[1
]}

Kim, Dae Hwan ^{[1
]}

Lee, Jun Hyung ^{[1
]}

Jeon, Jun Bok ^{[1
]}

Jang, Il-Tae ^{[1
]}

机构：

[1] Nanoori Gangnam Hosp, Spine Surg, Seoul, South Korea

[2] Natl Univ Hlth Syst, Orthopaed Surg, JurongHlth Campus, Singapore, Singapore

来源：

OPERATIVE NEUROSURGERY | 2022年 / 22卷 / 06期

关键词：

Thoracic myelopathy; Ossified ligamentum flavum; Thoracic endoscopic spine surgery; Endoscopic decompression; Open spinal decompression; LUMBAR INTERBODY FUSION; CONTRALATERAL APPROACH; OSSIFICATION; MYELOPATHY; COMPLICATIONS; DISKECTOMY; OUTCOMES; STENOSIS;

D O I：

10.1227/ons.0000000000000145

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND: Symptomatic thoracic myelopathy secondary to thoracic ossified ligamentum flavum (OLF) often requires decompression spinal surgery. OBJECTIVE: To compare clinical and radiological outcomes in uniportal endoscopic vs open thoracic decompression for thoracic OLF. METHODS: Retrospective evaluation of patients who underwent uniportal thoracic endoscopic unilateral laminotomy with bilateral decompression (TE-ULBD) by using the one-block resection technique compared with thoracic open laminotomy (TOL) with bilateral decompression. Radiological outcomes in MRI scan and clinical charts were evaluated. RESULTS: Thirty-five levels of TE-ULBD were compared with 24 levels of TOL. The overall complication rate of TOL was 15% while TE-ULBD was 6.5%. Both TOL and TE-ULBD cohort had significantly improved their visual analog scale (VAS), Oswestry Disability Index, and Japanese Orthopaedic Association (JOA) myelopathy score after operation. Comparative analysis of TE-ULBD performed statistically and significantly better than TOL in improvement of final VAS and JOA scores. The mean difference +/- standard deviation of VAS and JOA improvement in final follow-up when compared with preoperative state of TE-ULBD and TOL was 0.717 +/- 0.131 and 1.03 +/- 0.2, respectively, P < .05. The mean Hirabayashi recovery rates were 94.5% (TE-ULBD) and 56.8% (TOL). There was no statistical difference in change in preoperative and final Oswestry Disability Index and MRI volume at upper endplate, middisk, and lower endplate canal cross-sectional area. CONCLUSION: Uniportal TE-ULBD achieved significantly improved pain and neurological recovery with sufficient spinal canal decompression, as compared with thoracic open laminectomy for patients with myelopathy secondary to OLF in our cohort.

引用

页码：391 / 399

页数：9