Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum

• Published in: Scientific reports Vol. 10; no. 1; p. 1305
• Main Authors: Li, Xingchen, An, Bo, Gao, Haoran, Zhou, Chengpei, Zhao, Xiaobing, Ma, Haijun, Wang, Bisheng, Yang, Hejun, Zhou, Honggang, Guo, Xinjun, Zhu, Huimin, Qian, Jixian
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.01.2020; Nature Publishing Group
• Subjects: 692/499; 692/699/375/1824; 692/700/565/545/379; Adult; Aged; Aged, 80 and over; Anesthesia; Central nervous system diseases; Decompression; Decompression, Surgical - methods; Endoscopy; Female; Humanities and Social Sciences; Humans; Injuries; Ligamentum Flavum - pathology; Magnetic resonance imaging; Male; Middle Aged; Minimally Invasive Surgical Procedures - methods; multidisciplinary; Neuroendoscopy - methods; Ossification; Ossification, Heterotopic - complications; Ossification, Heterotopic - pathology; Patients; Prognosis; Regression analysis; Science; Science (multidisciplinary); Spinal cord; Spinal Cord Compression - diagnosis; Spinal Cord Compression - etiology; Spinal Cord Compression - surgery; Surgery; Surgery, Computer-Assisted; Thorax; Tomography, X-Ray Computed
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-58198-x

Minimally invasive surgery (MIS) has shown satisfactory surgical results for the treatment of thoracic myelopathy (TM) caused by ossification of the ligamentum flavum (OLF). This study investigated the prognostic factors following MIS and was based on the retrospective analysis of OLF patients who underwent percutaneous full endoscopic posterior decompression (PEPD). Thirty single-segment OLF patients with an average age of 60.4 years were treated with PEPD under local anaesthesia. Clinical data were collected from the medical and operative records. The surgical results were assessed by the recovery rate (RR) calculated from the modified Japanese Orthopaedic Association (mJOA) score. Correlations between the RR and various factors were analysed. Patients’ neurological status improved from a preoperative mJOA score of 6.0 ± 1.3 to a postoperative mJOA score of 8.5 ± 2.0 ( P  < 0.001) at an average follow-up of 21.3 months. The average RR was 53.8%. Dural tears in two patients (6.7%, 2/30) were the only observed complications. Multiple linear regression analysis showed that a longer duration of preoperative symptoms and the presence of a high intramedullary signal on T2-weighted MRI (T2HIS) were significantly associated with poor surgical results. PEPD is feasible for the treatment of TM patients with a particular type of OLF. Patients without T2HIS could achieve a good recovery if they received PEPD early.