caa a22 4500 445834781 CHVBK 20180317145327.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00586-010-1515-6 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1515-6 Clinical analysis of thoracic ossified ligamentum flavum without ventral compressive lesion [Elektronische Daten] [Sang Yoon, Wook Kim, Sang-Bong Chung, Yong Jin, Kun Park, Joon Lee, Sang-Ki Chung, Ki-jeong Kim, Jin Yeom, Tae-Ahn Jahng, Chun Chung, Heung Kang, Hyun-Jib Kim] The aim of this study was to analyze the clinical characteristics of thoracic ossified ligamentum flavum (OLF) and to elucidate prognostic factors as well as effective surgical treatment modality. The authors analyzed 106 thoracic OLF cases retrospectively from January 1999 to December 2008. The operative (n=40) and the non-operative group (n=66) were diagnosed by magnetic resonance imaging (MRI) and/or computed tomography (CT) imaging. We excluded cases exhibiting ventral compressive lesions causing subarachnoid space effacement in thoracic vertebrae as well as those with a coexisting cervical compressive myelopathy. Those in the operative group were treated with decompressive laminectomy as well as resection of OLF. The preoperative neurologic status and postoperative outcomes of patients, as indicated by their modified Japanese Orthopedic Association (mJOA) scores and recovery rate (RR), Modic changes, the axial (fused or non-fused) and sagittal (omega or beak) configurations of OLF, and the ratios of the cross-sectional area (CSA) and anteroposterior diameter (APD) of the most compressed level were studied. The most commonly affected segment was the T10-11 vertebral body level (n=49, 27.1%) and the least affected segment was the T7-8 level (n=1, 0.6%). The ratios of the CSA in non-fused and fused types were 77.3 and 59.3% (p<0.001). When Modic changes were present with OLF, initial mJOA score was found to be significantly lower than those without Modic change (7.62 vs. 9.09, p=0.033). Neurological status improved after decompressive laminectomy without fusion (preoperative vs. last mJOA; 7.1±2.01 vs. 8.57±1.91, p<0.001). However, one patient exhibited transient deterioration of her neurological status after surgery. In the axial configuration, fused-type OLF revealed a significant risk for a decreased postoperative mJOA score (0-7, severe and moderate) (Odds ratio: 5.54, χ 2=4.41, p=0.036, 95% CI: 1.014-30.256). The results indicated that the new categorization of axial-type of OLF is a helpful predictor of postoperative patient outcome and fused type was related with poor prognosis. In OLF cases free from ventral lesions compressing the spinal cord, decompressive laminectomy is enough for successful surgical outcome. Therefore, early surgical treatment will be considered in cases with fused-type OLF compressing spinal cord even though they do not have myelopathic symptoms. Springer-Verlag, 2010 Thoracic nationallicence Ossified ligamentum flavum nationallicence Compressive myelopathy nationallicence Axial type nationallicence Laminectomy nationallicence Yoon Sang Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut Kim Wook Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut Chung Sang-Bong Department of Neurosurgery, The Armed Forces Capital Hospital, Gyeonggi-do, South Korea aut Jin Yong Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut Park Kun Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut Lee Joon Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut Chung Sang-Ki Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut Kim Ki-jeong Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut Yeom Jin Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut Jahng Tae-Ahn Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea aut Chung Chun Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea aut Kang Heung Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut Kim Hyun-Jib Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut European Spine Journal Springer-Verlag 20/2(2011-02-01), 216-223 0940-6719 20:2<216 2011 20 586 https://doi.org/10.1007/s00586-010-1515-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1515-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yoon Sang Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Kim Wook Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Chung Sang-Bong Department of Neurosurgery, The Armed Forces Capital Hospital, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Jin Yong Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Park Kun Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Lee Joon Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Chung Sang-Ki Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Kim Ki-jeong Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Yeom Jin Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Jahng Tae-Ahn Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Chung Chun Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Kang Heung Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, South Korea aut NATIONALLICENCE 700 1- Kim Hyun-Jib Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, Gyeonggi-do, South Korea aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/2(2011-02-01), 216-223 0940-6719 20:2<216 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer