How i do it: biportal endoscopic thoracic decompression for ossification of the ligamentum flavum

2021 ◽  
Author(s):  
Min-Seok Kang ◽  
Hoon-Jae Chung ◽  
Ki-Han You ◽  
Hyun-Jin Park
Keyword(s):  
Ligamentum Flavum ◽  
Thoracic Decompression

Factors for a Good Surgical Outcome in Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Thoracic Ossification of the Posterior Longitudinal Ligament: Prospective Single-Center Study

2017 ◽  
Vol 13 (6) ◽  
pp. 661-669 ◽  
Author(s):  
Shiro Imagama ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Tetsuro Hida ◽  
Kenyu Ito ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Outcomes ◽  
Ligamentum Flavum ◽  
Posterior Longitudinal Ligament ◽  
Neurophysiological Monitoring ◽  
Posterior Decompression ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Estimated Blood Loss ◽  
Significant Factors

Abstract BACKGROUND Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown. OBJECTIVE To identify factors for good surgical outcomes with prospective and comparative study. METHODS Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and <50% recovery rates for the Japanese Orthopaedic Association score. Preoperative, intraoperative, and postoperative findings were compared in the 2 groups, and significant factors for a good outcome were analyzed. RESULTS Patients with a good outcome (76%) had significantly lower nonambulatory rate and positive prone and supine position tests preoperatively; lower rates of T-OPLL, ossification of the ligamentum flavum, high-intensity area at the same level, thoracic spinal cord alignment difference, and spinal canal stenosis on preoperative magnetic resonance imaging; lower estimated blood loss; higher rates of intraoperative spinal cord floating and absence of deterioration of intraoperative neurophysiological monitoring; and lower rates of postoperative complications (P < .0005). In multivariate logistic regression analysis, negative prone and supine position test (odds ratio [OR]: 17.00), preoperative ambulatory status (OR: 6.05), absence of T-OPLL, ossification of the ligamentum flavum, high-intensity area at the same level (OR: 5.84), intraoperative spinal cord floating (OR: 4.98), and lower estimated blood loss (OR: 1.01) were significant factors for a good surgical outcome. CONCLUSION This study demonstrated that early surgery is recommended during these positive factors. Appropriate surgical planning based on preoperative thoracic spinal cord alignment difference, as well as sufficient spinal cord decompression and reduction of complications using intraoperative ultrasonography and intraoperative neurophysiological monitoring, may improve surgical outcomes.

scholarly journals Thoracic myelopathy caused by ossification of ligamentum flavum of which fluorosis as an etiology factor

2007 ◽  
Vol 2 (1) ◽  
pp. 6 ◽  
Author(s):  
Wenbao Wang ◽  
Linghua Kong ◽  
Heyuan Zhao ◽  
Ronghua Dong ◽  
Jing Zhou ◽  
...  
Keyword(s):  
Ligamentum Flavum ◽  
Thoracic Myelopathy ◽  
Ossification Of Ligamentum Flavum

Thoracic spinal cord injury without major bone injury associated with ossification of the ligamentum flavum

2019 ◽  
Vol 24 (1) ◽  
pp. 174-177 ◽  
Author(s):  
Masaaki Machino ◽  
Shiro Imagama ◽  
Keigo Ito ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ligamentum Flavum ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Bone Injury ◽  
Cord Injury

Hematoma of the ligamentum flavum in the lumbar spine:

2000 ◽  
Vol 53 (6) ◽  
pp. 598-600 ◽  
Author(s):  
Nurullah Yüceer ◽  
Mustafa K Baskaya ◽  
Patricia Smith ◽  
Brian K Willis
Keyword(s):  
Lumbar Spine ◽  
Ligamentum Flavum

MYELOPATHY DUE TO OSSIFICATION OR CALCIFICATION OF THE LIGAMENTUM FLAVUM

1983 ◽  
Vol 7 (1) ◽  
pp. 201 ◽  
Author(s):  
Kazuo Miyasaka ◽  
Toyohiko Isu ◽  
Satoru Abe ◽  
Hidetoshi Takei ◽  
Kiyoshi Kaneda ◽  
...  
Keyword(s):  
Ligamentum Flavum

Morphologic and histologic study of the ligamentum flavum in the thoraco-lumbar region

1998 ◽  
Vol 20 (3) ◽  
pp. 171-176 ◽  
Author(s):  
D. Viejo-Fuertes ◽  
D. Liguoro ◽  
J. Rivel ◽  
D. Midy ◽  
J. Guerin
Keyword(s):  
Ligamentum Flavum ◽  
Lumbar Region ◽  
Histologic Study

Cervical Automated Discectomy

1996 ◽  
Vol 2 (1) ◽  
pp. 35-44 ◽  
Author(s):  
J. Theron ◽  
H. Huet ◽  
O. Coskun
Keyword(s):  
Medical Treatment ◽  
Success Rate ◽  
Open Surgery ◽  
Ligamentum Flavum ◽  
Outpatient Basis ◽  
Complementary Technique ◽  
First Choice ◽  
Lumbar Area ◽  
Safe Technique ◽  
Cervical Disk

The lumbar automated discectomy system described by Onik has been used in the treatment of cervical disk herniations whose symptomatology resisted medical treatment. Experience on 150 patients is reported showing a 74.5% success rate. This series performed in most cases on an outpatient basis had no complications. Up to 1992 failure cases were treated by intradiscal injections of triamcinolone with 62% of success. This complementary technique was abandonned after the description of epidural calcifications secondary to this type of injections in the lumbar area. Since 1992, failure cases have been managed differently with injections of steroids in the cervical joints, especially when a hypertrophy of the ligamentum flavum supposedly a sign of an inflammatory posterior component of the pain was demonstrated on the CT. Nine patients received intradiscal injections of microdoses (600 IU) of chymopapaine with excellent results. No patient has had open surgery since 1992. It is concluded that percutaneous automated discectomy is a very promising and safe technique which can be used as a first choice technique for most cervical disk herniations resisting medical treatment.

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