Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum
Minimally invasive surgery (MIS) has shown satisfactory surgical results for the treatment of thoracic myelopathy (TM) caused by ossification of the ligamentum flavum (OLF). This study investigated the prognostic factors following MIS and was based on the retrospective analysis of OLF patients who u...
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| description | Minimally invasive surgery (MIS) has shown satisfactory surgical results for the treatment of thoracic myelopathy (TM) caused by ossification of the ligamentum flavum (OLF). This study investigated the prognostic factors following MIS and was based on the retrospective analysis of OLF patients who underwent percutaneous full endoscopic posterior decompression (PEPD). Thirty single-segment OLF patients with an average age of 60.4 years were treated with PEPD under local anaesthesia. Clinical data were collected from the medical and operative records. The surgical results were assessed by the recovery rate (RR) calculated from the modified Japanese Orthopaedic Association (mJOA) score. Correlations between the RR and various factors were analysed. Patients’ neurological status improved from a preoperative mJOA score of 6.0 ± 1.3 to a postoperative mJOA score of 8.5 ± 2.0 (
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| doi_str_mv | 10.1038/s41598-020-58198-x |
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P
< 0.001) at an average follow-up of 21.3 months. The average RR was 53.8%. Dural tears in two patients (6.7%, 2/30) were the only observed complications. Multiple linear regression analysis showed that a longer duration of preoperative symptoms and the presence of a high intramedullary signal on T2-weighted MRI (T2HIS) were significantly associated with poor surgical results. PEPD is feasible for the treatment of TM patients with a particular type of OLF. Patients without T2HIS could achieve a good recovery if they received PEPD early.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-58198-x</identifier><identifier>PMID: 31992790</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/499 ; 692/699/375/1824 ; 692/700/565/545/379 ; Adult ; Aged ; Aged, 80 and over ; Anesthesia ; Central nervous system diseases ; Decompression ; Decompression, Surgical - methods ; Endoscopy ; Female ; Humanities and Social Sciences ; Humans ; Injuries ; Ligamentum Flavum - pathology ; Magnetic resonance imaging ; Male ; Middle Aged ; Minimally invasive surgery ; Minimally Invasive Surgical Procedures - methods ; multidisciplinary ; Neuroendoscopy - methods ; Ossification ; Ossification, Heterotopic - complications ; Ossification, Heterotopic - pathology ; Patients ; Prognosis ; Regression analysis ; Science ; Science (multidisciplinary) ; Spinal cord ; Spinal Cord Compression - diagnosis ; Spinal Cord Compression - etiology ; Spinal Cord Compression - surgery ; Surgery ; Surgery, Computer-Assisted ; Thorax ; Tomography, X-Ray Computed</subject><ispartof>Scientific reports, 2020-01, Vol.10 (1), p.1305-1305, Article 1305</ispartof><rights>The Author(s) 2020</rights><rights>This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-38159b3f874019a581b87e4f9f5b11b82a3d89c1a9d7c36f9bf2be4c9e72eb2c3</citedby><cites>FETCH-LOGICAL-c540t-38159b3f874019a581b87e4f9f5b11b82a3d89c1a9d7c36f9bf2be4c9e72eb2c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987090/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6987090/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,41120,42189,51576,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31992790$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Xingchen</creatorcontrib><creatorcontrib>An, Bo</creatorcontrib><creatorcontrib>Gao, Haoran</creatorcontrib><creatorcontrib>Zhou, Chengpei</creatorcontrib><creatorcontrib>Zhao, Xiaobing</creatorcontrib><creatorcontrib>Ma, Haijun</creatorcontrib><creatorcontrib>Wang, Bisheng</creatorcontrib><creatorcontrib>Yang, Hejun</creatorcontrib><creatorcontrib>Zhou, Honggang</creatorcontrib><creatorcontrib>Guo, Xinjun</creatorcontrib><creatorcontrib>Zhu, Huimin</creatorcontrib><creatorcontrib>Qian, Jixian</creatorcontrib><title>Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>Minimally invasive surgery (MIS) has shown satisfactory surgical results for the treatment of thoracic myelopathy (TM) caused by ossification of the ligamentum flavum (OLF). This study investigated the prognostic factors following MIS and was based on the retrospective analysis of OLF patients who underwent percutaneous full endoscopic posterior decompression (PEPD). Thirty single-segment OLF patients with an average age of 60.4 years were treated with PEPD under local anaesthesia. Clinical data were collected from the medical and operative records. The surgical results were assessed by the recovery rate (RR) calculated from the modified Japanese Orthopaedic Association (mJOA) score. Correlations between the RR and various factors were analysed. Patients’ neurological status improved from a preoperative mJOA score of 6.0 ± 1.3 to a postoperative mJOA score of 8.5 ± 2.0 (
P
< 0.001) at an average follow-up of 21.3 months. The average RR was 53.8%. Dural tears in two patients (6.7%, 2/30) were the only observed complications. Multiple linear regression analysis showed that a longer duration of preoperative symptoms and the presence of a high intramedullary signal on T2-weighted MRI (T2HIS) were significantly associated with poor surgical results. PEPD is feasible for the treatment of TM patients with a particular type of OLF. Patients without T2HIS could achieve a good recovery if they received PEPD early.</description><subject>692/499</subject><subject>692/699/375/1824</subject><subject>692/700/565/545/379</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia</subject><subject>Central nervous system diseases</subject><subject>Decompression</subject><subject>Decompression, Surgical - methods</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Injuries</subject><subject>Ligamentum Flavum - pathology</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minimally invasive surgery</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>multidisciplinary</subject><subject>Neuroendoscopy - methods</subject><subject>Ossification</subject><subject>Ossification, Heterotopic - complications</subject><subject>Ossification, Heterotopic - pathology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Spinal cord</subject><subject>Spinal Cord Compression - diagnosis</subject><subject>Spinal Cord Compression - etiology</subject><subject>Spinal Cord Compression - surgery</subject><subject>Surgery</subject><subject>Surgery, Computer-Assisted</subject><subject>Thorax</subject><subject>Tomography, X-Ray Computed</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kstu1TAQhiMEolXpC7BAltiwCfiSNPEGCVXcpEosgLXlOOMcV04cfGl7XopnZE5TSmGBNx7Z3_ye-T1V9ZzR14yK_k1qWCv7mnJatz3D6OZRdcxp09ZccP74QXxUnaZ0SXG1XDZMPq2OBJOSd5IeVz-_ljg5oz2JkIrPiehlJGsM0xJSdoZYbXKIidjgfbh2y0RWiKZkvUAoeFy8J7CMIZmwIr5iFkQXIhnBhHlF1eTCgumR5F2I2iA078GHVefdnhhdEoxk2JOAoMVK8gEPFmkg3k16hiWXmVivr8r8rHpitU9werefVN8_vP92_qm--PLx8_m7i9q0Dc216NGcQdi-ayiTGg0a-g4aK207MIy5FmMvDdNy7Iw4s3KwfIDGSOg4DNyIk-rtpruWYYbRYA1Re7VGN-u4V0E79ffN4nZqClfqTPYdlRQFXt0JxPCjQMpqdsmA95tvioum50xyfkBf_oNehhIXbO-WYoxJypHiG2UiOhXB3hfDqDpMhNomQuFEqNuJUDeY9OJhG_cpv_8fAbEBCa-WCeKft_8j-wtMuckt</recordid><startdate>20200128</startdate><enddate>20200128</enddate><creator>Li, Xingchen</creator><creator>An, Bo</creator><creator>Gao, Haoran</creator><creator>Zhou, Chengpei</creator><creator>Zhao, Xiaobing</creator><creator>Ma, Haijun</creator><creator>Wang, Bisheng</creator><creator>Yang, Hejun</creator><creator>Zhou, Honggang</creator><creator>Guo, Xinjun</creator><creator>Zhu, Huimin</creator><creator>Qian, Jixian</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200128</creationdate><title>Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum</title><author>Li, Xingchen ; An, Bo ; Gao, Haoran ; Zhou, Chengpei ; Zhao, Xiaobing ; Ma, Haijun ; Wang, Bisheng ; Yang, Hejun ; Zhou, Honggang ; Guo, Xinjun ; Zhu, Huimin ; Qian, Jixian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-38159b3f874019a581b87e4f9f5b11b82a3d89c1a9d7c36f9bf2be4c9e72eb2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>692/499</topic><topic>692/699/375/1824</topic><topic>692/700/565/545/379</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia</topic><topic>Central nervous system diseases</topic><topic>Decompression</topic><topic>Decompression, Surgical - methods</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Injuries</topic><topic>Ligamentum Flavum - pathology</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minimally invasive surgery</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>multidisciplinary</topic><topic>Neuroendoscopy - methods</topic><topic>Ossification</topic><topic>Ossification, Heterotopic - complications</topic><topic>Ossification, Heterotopic - pathology</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Regression analysis</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Spinal cord</topic><topic>Spinal Cord Compression - diagnosis</topic><topic>Spinal Cord Compression - etiology</topic><topic>Spinal Cord Compression - surgery</topic><topic>Surgery</topic><topic>Surgery, Computer-Assisted</topic><topic>Thorax</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Xingchen</creatorcontrib><creatorcontrib>An, Bo</creatorcontrib><creatorcontrib>Gao, Haoran</creatorcontrib><creatorcontrib>Zhou, Chengpei</creatorcontrib><creatorcontrib>Zhao, Xiaobing</creatorcontrib><creatorcontrib>Ma, Haijun</creatorcontrib><creatorcontrib>Wang, Bisheng</creatorcontrib><creatorcontrib>Yang, Hejun</creatorcontrib><creatorcontrib>Zhou, Honggang</creatorcontrib><creatorcontrib>Guo, Xinjun</creatorcontrib><creatorcontrib>Zhu, Huimin</creatorcontrib><creatorcontrib>Qian, Jixian</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>ProQuest Biological Science Journals</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Xingchen</au><au>An, Bo</au><au>Gao, Haoran</au><au>Zhou, Chengpei</au><au>Zhao, Xiaobing</au><au>Ma, Haijun</au><au>Wang, Bisheng</au><au>Yang, Hejun</au><au>Zhou, Honggang</au><au>Guo, Xinjun</au><au>Zhu, Huimin</au><au>Qian, Jixian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2020-01-28</date><risdate>2020</risdate><volume>10</volume><issue>1</issue><spage>1305</spage><epage>1305</epage><pages>1305-1305</pages><artnum>1305</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>Minimally invasive surgery (MIS) has shown satisfactory surgical results for the treatment of thoracic myelopathy (TM) caused by ossification of the ligamentum flavum (OLF). This study investigated the prognostic factors following MIS and was based on the retrospective analysis of OLF patients who underwent percutaneous full endoscopic posterior decompression (PEPD). Thirty single-segment OLF patients with an average age of 60.4 years were treated with PEPD under local anaesthesia. Clinical data were collected from the medical and operative records. The surgical results were assessed by the recovery rate (RR) calculated from the modified Japanese Orthopaedic Association (mJOA) score. Correlations between the RR and various factors were analysed. Patients’ neurological status improved from a preoperative mJOA score of 6.0 ± 1.3 to a postoperative mJOA score of 8.5 ± 2.0 (
P
< 0.001) at an average follow-up of 21.3 months. The average RR was 53.8%. Dural tears in two patients (6.7%, 2/30) were the only observed complications. Multiple linear regression analysis showed that a longer duration of preoperative symptoms and the presence of a high intramedullary signal on T2-weighted MRI (T2HIS) were significantly associated with poor surgical results. PEPD is feasible for the treatment of TM patients with a particular type of OLF. Patients without T2HIS could achieve a good recovery if they received PEPD early.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>31992790</pmid><doi>10.1038/s41598-020-58198-x</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 692/499 692/699/375/1824 692/700/565/545/379 Adult Aged Aged, 80 and over Anesthesia Central nervous system diseases Decompression Decompression, Surgical - methods Endoscopy Female Humanities and Social Sciences Humans Injuries Ligamentum Flavum - pathology Magnetic resonance imaging Male Middle Aged Minimally invasive surgery Minimally Invasive Surgical Procedures - methods multidisciplinary Neuroendoscopy - methods Ossification Ossification, Heterotopic - complications Ossification, Heterotopic - pathology Patients Prognosis Regression analysis Science Science (multidisciplinary) Spinal cord Spinal Cord Compression - diagnosis Spinal Cord Compression - etiology Spinal Cord Compression - surgery Surgery Surgery, Computer-Assisted Thorax Tomography, X-Ray Computed |
| title | Surgical results and prognostic factors following percutaneous full endoscopic posterior decompression for thoracic myelopathy caused by ossification of the ligamentum flavum |
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