Clinical Characteristics And Analysis Of The Factors Related To Outcome For The Ossification Of Ligamentum Flavum Of Thoracic Spine

Objective To investigate the clinical characteristcs of the ossification of ligamentum flavum (OLF) of thoracic spine, and to analyze the factors related to outcome.Methods We studied 28 patients who underwent surgical treatment to thoracic OLF in the orthopedic department of the second affliated hospital of chongqing medical university from June of 2001 to June of 2010. Patients were evaluated pre- and postoperatively using the modified Japanese Orthopedic Association (JOA) scale (maximum total score of 11) and recovery rate (RR). And Pearson correlations were analyzed among RR and undermentioned parameters.Results The most common sympoms were numbness (78.6%) and motor dysfunction (71.4%) in the lower extremities. The mean preoperative JOA score of 4.5±2.2 improved to a mean score of 8.5±2.6 at the last follow-up. The mean RR was (59.2±28.2)%, and the excellent and good rate was 78.6%, fair rate 89.3%. Patients with short disease course, high preoperative JOA scores, and without intramedullary signal change on MRI had good surgical results. The patients whose disease course <6 months and preoperative JOA scores >3 had obviously higher RR.Conclusions Duration of symptoms, preoperative JOA score and intramedullary signal change on MRI were important predictive factors of surgical outcome for thoracic OLF. Diagnosis in early period and the operations of decompression could supply the OLF patients with symptoms alleviating and neurological recovery. The operations should be done in the early stages before sensitive and motive injury and sphincter dysfunction.