Pathological Typing Of Thoracic Spinal Stenosis And Investigation Of Corresponding Countermeasure (Attached A Report Of 23 Cases)

Object: To report 23 cases of thoracic spinal stenosis in our department. Evaluate the prognosis of patients who are treated by surgical methods, Explore the diagnosis and treatment of thoracic spinal stenosis, deepen the understanding of thoracic spinal stenosis.Materials and Methods: To summarize the clinical features of 23 patients with comparatively integrated materials of 33 thoracic spinal stenosis from October 2006 to April 2009 in our department,using a retrospective study method , Analysis the clinical manifestations, imaging features, operation methods and the influence on the prognosis of patients after operation. All patients are diagnosed with thoracic spinal stenosis before operation, and are fit for and require for surgical treatment, All are examined conventionally by positive-side x-rays,multislice CT and MRI. The time of follow-up is about 15 months on the average . Assess the clinical effect on improved JOA assessment standards , Epstein standards,Mann standards of spinal cord function classification.Results:Improved JOA score is (5.011±0.858) on average preoperatively, and (8.824±0.934) on average postoperatively after follow-up. The difference between before and after operation has the statistically significant (paired t-test, P < 0.01). 8 excellent cases, 10 good cases, 4 improved cases, no change in 1 case, no aggravating case. The rate of excellent and good result is 78.3% (18 /23); the effective rate is 97.5% (22/23). According to Epstein standards: 11 excellent cases, 9 good cases, 2 patients not very good,l no good, and rate of excellent and good is 86.9% (20/ 23).According to the Mann classification standards of spinal cord: 8 cases ofⅠlevel(completely recovery), 11 patients ofⅡlevel, 3 cases ofⅢgrade, 0 ofⅣlevel, 1 ofⅤlevel. The rate of excellent and good is 82.6% (19/23).Concusions:The clinical manifestations of thoracic spinal stenosis is lack of specificity,We should diagnosis it combine imaging manifestations. The results of X-ray, CT and MRI have the guiding significance for the diagnosis and treatment. According to the relationship of the properties leading to pressure and the spinal cord, we should make a rational choice of decompression surgery, Especially in the way of giving the type of surgery of thoracic spinal stenosis ,we will have more clear choice.