Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

Abstract

A retrospective clinical study of 19 cases of ossification of ligamentum flavum (OLF) in Chinese population. To inspect the epidemiology, clinical presentation, pathology, radiologic findings, and treatment outcome in 19 Chinese patients of OLF at a single institution. OLF in the thoracic region causing neurological impairment is a rare pathologic entity described mainly in Japanese literature. The present study represents a series of Chinese patients with OLF at the thoracic spine. Nineteen patients (7 male and 12 female; ages ranging between 39 and 73 y) were included in this study. All patients have been treated by posterior thoracic extensive decompressive laminectomy. Neurological status was evaluated using the Japanese Orthopedic Association (JOA) score, the recovery rate, and the Oswestry Disability Index (ODI) before and after surgery. Patients' pain relief was evaluated using a visual analog scale (VAS) pain score. Mean JOA score was 3.16±1.05 before surgery to 8.34±3.28 after surgery. Mean recovery rate was 61.4%±32.5%. Mean ODI scores had significantly decreased from 66.36%±10.91% before surgery to 25.45%±12.19% after surgery. The result of VAS score were 6.29±1.83 before the operation and 2.18±1.90 at final follow-up. All patients improved at the end of the evaluation period. There was no recurrence. Early diagnosis and sufficient surgical treatment play key roles in improving functional outcomes. Posterior thoracic extensive decompressive laminectomy gives satisfactory results and leads to significant clinical improvement.