Surgical Outcome And Analysis Of The Associated Factors Of The Thoracic Spinal Stenosis Following Posterior Approach Surgery

Objective:To assess the efficacy of posterior approach surgery and the factors related to the surgical outcome for the thoracic spinal stenosis. Methods:56 patients with throracic spinal stenosis undergoing posterior approach surgery from January 2008 to January 2015 were reviewed retrospectively. TSS patients with cervicle or lumbar diseases or spinal tuberculosis, tumor, trauma, etc were excluded.we evaluated surgical outcome with modified Japanese orthopaedic association scale(maximum total score of11) and recovery rate(RR). Pearson correlations were analyzed among RR and the parameters including age, smoking history, intramedullary signal change in MRI T2 WI, bleeding amount, operation section, preoperative course of disease and JOA score. Using SPSS19.0 statistical software for statistical analysis, P < 0.05 as statistically significant criteria. Results:56 patients with complete follow-up data(26 males and 30 females) were included in this study.The mean follow up duration were 31.2 months and the mean preoperative JOA score of 4.70±1.72 improved to a mean score of 8.38±2.44 at the last follow up.The excellent and good rate was 76.79%, the fair rate was 89.29%.The efficacy of TSS following posterior surgery related to disease course, preoperative JOA scores, intramedullary signal change on MRI,and operation section and amout of bleeding. The patients whose disease course <6months and preoperative JOA scores <3 or the operation section lies in T4-T9 had obviously lower RR, Whereas the history of smoking and the age of TSS patient have no obvious correlation with the final surgical outcome. Conclusion:The posterior approach surgery is effective for thoracic spinal stenosis. intramedullary signal change in MRI T2 WI, bleeding amount, operation section, preoperative duration and JOA score have significant effect on surgical outcome.early diagnosis and the effective surgical decompression is critical for thoracic spinal stenosis.