J Korean Neurosurg Soc.  2002 Nov;32(5):424-430.

Surgical Outcome and Prognostic Factors of Ossified Ligamentum Flavum of the Thoracic Spine

• Cho YH
• Moon SM
• Roh SW
• Joen SR
• Rhim SC

Abstract

OBJECTIVE
The aim of this study is to describe the surgical outcome and determine prognostic factors of thoracic ossified ligamentum flavum(OLF).
METHODS
From April 1998 to November 2001, 32 consecutive patients with symptomatic thoracic OLF were treated surgically in our institution. Among them, the authors conducted a retrospective analysis of 28 patients in whom preoperative magnetic resonance imaging and computed tomogram were available. Decompressive laminectomy including removal of OLF mass was performed in each case. Mean follow-up period was 25.2 months, ranged from 3 to 46 months.
RESULTS
Twenty-two patients(79%) showed functional improvement, in whom average Nurick Grade changed from 3.6 to 2.5 after surgery. Fifteen of eighteen patients presented with motor weakness, six of seven with leg or back pain and one of three with leg numbness or paresthesia improved respectively. No patient had deteriorated postoperatively. Clinical presentation and preoperative Nurick Grade were significant predictive factors for surgical outcome(p=0.004 and p<0.001, respectively). In addition, combined facet joint hypertrophy and/or compressive anterior element indicated poor prognosis(p=0.008).
CONCLUSION
Appropriate evaluation and sufficient surgical decompression for combined compressive elements on imaging study could improve the functional prognosis in thoracic OLF.

Keyword

Ossified ligamentum flavum; Thoracic spine; Prognostic factors; Decompressive laminectomy

MeSH Terms

Back Pain
Decompression, Surgical
Follow-Up Studies
Humans
Hypertrophy
Hypesthesia
Laminectomy
Leg
Ligamentum Flavum*
Magnetic Resonance Imaging
Paresthesia
Prognosis
Retrospective Studies
Spine*
Zygapophyseal Joint