Clinical observation of subsection laminectomy spinal decompression combined with internal fixation in the treatment of thoracic ossification of the ligamentum flavum

ObjectiveTo investigate the clinical efficacy and safety of subsection laminectomy spinal decompression combined with internal fixation in the treatment of thoracic ossification of the ligamentum flavum(T-OLF).

MethodsThe clinical data of 58 patients with T-OLF were retrospectively analyzed.According to the surgical method, the patients were divided into the group A(25 cases) and group B(21 cases).According to the anatomical characteristics of ligamentum flavum and its adjacent relationship with the vertebral plate, the posterior region of the vertebral plate was divided, and the vertebral plate decompression, segmental resection and spinal cord decompression were performed in group A.The group B was treated with laminae thinning and decompression combined with internal fixation.The operative time, intraoperative blood loss and complications were recorded, and the recovery of neurological function and change of local kyphosis were observed in two groups.

ResultsThe differences of the operative time and blood loss between two groups were not statistically significant(P>0.05), and the JOA scores in two groups significantly increased compared with those before surgery(P < 0.05).The neurological improvement rate in group A and group B was(72.2±14.8)% and(73.1±15.2)%, respectively, and the difference of which was not statistically significant(P>0.05).The Cobb angles in two groups were significantly improved compared with preoperative level(P < 0.01), and there was no statistical significance between two groups at different time points(P>0.05).The difference of the incidence rate of cerebrospinal fluid leakage between group A(12.00%) and group B(23.80%) was statistically significant(P < 0.05).

ConclusionsThe subsection laminectomy spinal decompression combined with internal fixation can reduce the invasive operation in the spinal canal, the incidence of dural tear is low, the safety is relatively high, and the internal fixation implantation is beneficial to better maintain the stability of thoracic vertebra after operation.