Objective To investigate the surgical techniqueand efficiency of the "Cave-in" 360° circumferential decompression for thoracic spinal stenosis(TSS)with ossification of posterior longitudinal ligament(OP...Objective To investigate the surgical techniqueand efficiency of the "Cave-in" 360° circumferential decompression for thoracic spinal stenosis(TSS)with ossification of posterior longitudinal ligament(OPLL).Methods From October 2005 to展开更多
The surgical outcomes of decompression for thoracic spinal stenosis （TSS） are unfavorable. The purpose of this study was to determine the efficacy of intraoperative ultrasonography during ＂cave-in＂ 360~ circumfere...The surgical outcomes of decompression for thoracic spinal stenosis （TSS） are unfavorable. The purpose of this study was to determine the efficacy of intraoperative ultrasonography during ＂cave-in＂ 360~ circumferential decompression surgery in patients with TSS. Methods Thirteen patients with TSS underwent ＂cave-in＂ 360° circumferential decompression surgery between May 2010 and November 2010. Intraoperative ultrasonography was used after removal of the posterior wall of thoracic spinal canal to assess the morphologic restoration of the spinal cord and the anterior surface of the spinal canal. In seven patients, ultrasonography was used again after circumferential decompression to compare the cross-sectional area of the spinal cord before and after circumferential decompression. Results The average period of follow-up was （12±2） months （range 9-15 months）. The Japanese Orthopedic Association score was significantly higher at the final follow-up （8.5±2.1, range 3-10） than preoperatively （5.2±1.1, range 3-7; P 〈0.01）. The cross-sectional area of the spinal cord was （30.8±6.6） mm2 before and （53.6±19.1） mm2 after circumferential decompression （P 〈0.01）. For five patients with TSS caused by thoracic disc herniation, the levels of circumferential decompression performed corresponded to those expected preoperatively. In contrast, for eight patients with TSS caused by ossification of the posterior longitudinal ligament, on average 1.6±0.9 fewer levels of circumferential decompression were performed than expected preoperatively. Conclusions ＂Cave-in＂ 360° circumferential decompression is an effective therapeutic option for TSS. Intraoperative ultrasonographic evaluation may reduce the levels of circumferential decompression and ensure sufficient decomoression, and increase the efficacy of this surqical technique.展开更多
文摘Objective To investigate the surgical techniqueand efficiency of the "Cave-in" 360° circumferential decompression for thoracic spinal stenosis(TSS)with ossification of posterior longitudinal ligament(OPLL).Methods From October 2005 to
文摘The surgical outcomes of decompression for thoracic spinal stenosis （TSS） are unfavorable. The purpose of this study was to determine the efficacy of intraoperative ultrasonography during ＂cave-in＂ 360~ circumferential decompression surgery in patients with TSS. Methods Thirteen patients with TSS underwent ＂cave-in＂ 360° circumferential decompression surgery between May 2010 and November 2010. Intraoperative ultrasonography was used after removal of the posterior wall of thoracic spinal canal to assess the morphologic restoration of the spinal cord and the anterior surface of the spinal canal. In seven patients, ultrasonography was used again after circumferential decompression to compare the cross-sectional area of the spinal cord before and after circumferential decompression. Results The average period of follow-up was （12±2） months （range 9-15 months）. The Japanese Orthopedic Association score was significantly higher at the final follow-up （8.5±2.1, range 3-10） than preoperatively （5.2±1.1, range 3-7; P 〈0.01）. The cross-sectional area of the spinal cord was （30.8±6.6） mm2 before and （53.6±19.1） mm2 after circumferential decompression （P 〈0.01）. For five patients with TSS caused by thoracic disc herniation, the levels of circumferential decompression performed corresponded to those expected preoperatively. In contrast, for eight patients with TSS caused by ossification of the posterior longitudinal ligament, on average 1.6±0.9 fewer levels of circumferential decompression were performed than expected preoperatively. Conclusions ＂Cave-in＂ 360° circumferential decompression is an effective therapeutic option for TSS. Intraoperative ultrasonographic evaluation may reduce the levels of circumferential decompression and ensure sufficient decomoression, and increase the efficacy of this surqical technique.
