Abstract:
Background:There are many surgical procedures that can be used to relieve compression caused by thoracic ossification of the ligamentum flavum (TOLF). The present study aims to retrospectively observe the differences in subsection laminectomy with pedicle screw fixation (SLPF) and lamina osteotomy and replantation with miniplate fixation (LORF) in the treatment of continuous TOLF. Patients and Methods:From March 2014 to October 2017, 61 patients with continuous TOLF underwent SLPF (group A) or LORF (group B). The surgical duration, intraoperative blood loss, change in thoracic kyphosis, and perioperative complications were analyzed. Neurological function was evaluated in accordance with the Japanese Orthopedic Association (JOA) score and the American Spinal Injury Association (ASIA) neurological grading. Results:The surgical duration, intraoperative blood loss, and postoperative bed-rest duration in group A were significantly lower than those observed in group B (P < 0.05). Both groups demonstrated a significant improvement in JOA score and ASIA grade (P < 0.05). The neurological recovery rate was 69.8% ± 13.5% in group A and 68.5% ± 12.7% in group B (P > 0.05). There was also a significant improvement in ASIA grade at the final follow-up (P < 0.05). During follow-up, the Cobb angle was significantly increased in group B (P < 0.05), whereas no significant difference was observed in group A (P > 0.05). The occurrence rate of perioperative complications was 15.6% (5/32 patients) in group A and 37.9% (11/29 patients) in group B (P < 0.05). Conclusion:Both SLPF and LORF significantly promote recovery of neurological function. SLPF has a shorter surgical duration, less intraoperative blood loss, and a lower complication rate. SLPF is more conducive to the correction of sagittal sequence and maintenance of thoracic stability.
journal_name
Ther Clin Risk Managjournal_title
Therapeutics and clinical risk managementauthors
Zhang JT,Lei T,Yang L,Lin YS,Wang ZH,Cao JMdoi
10.2147/TCRM.S235868subject
Has Abstractpub_date
2020-04-17 00:00:00pages
311-319eissn
1176-6336issn
1178-203Xpii
235868journal_volume
16pub_type
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