Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum
Summary: Objective: Spinal cord injury is a common occurrence during spinal surgery. In this study, we proposed a zoning laminectomy, which could reduce the incidence of nerve injury. We also discussed the safety and clinical efficacy of the zoning laminectomy for thoracic ossification of the ligam...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958422008594 |
| _version_ | 1811173501058416640 |
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| author | Qiangqiang Pan Zhenhui Zhang Yanyu Zhu Wentao Jiang Kai Su Peilin Liu Yongsheng Kang Zhe Shao Wei Mei Qingde Wang |
| author_facet | Qiangqiang Pan Zhenhui Zhang Yanyu Zhu Wentao Jiang Kai Su Peilin Liu Yongsheng Kang Zhe Shao Wei Mei Qingde Wang |
| author_sort | Qiangqiang Pan |
| collection | DOAJ |
| description | Summary: Objective: Spinal cord injury is a common occurrence during spinal surgery. In this study, we proposed a zoning laminectomy, which could reduce the incidence of nerve injury. We also discussed the safety and clinical efficacy of the zoning laminectomy for thoracic ossification of the ligamentum flavum (TOLF). Methods: Forty-five patients with TOLF who underwent zoning laminectomy from October 2016 to February 2020 were included in the retrospective analysis. The Japan Orthopedic Association (JOA) score was used to evaluate clinical outcomes. Meanwhile, the occurrence of complications was recorded. Results: All 45 patients underwent the operation successfully, and the mean follow-up period was 25.3 months, the mean operation time was 160.2 min, the average blood loss was 474.2 ml, and the average hospital time was 8.0 days. At the final evaluation, the JOA score was significantly higher than the preoperative JOA score (P < 0.001) and the overall recovery rate of the JOA score averaged 69.6%. Seventeen patients were graded as excellent, twenty-six as good, and two as fair. The complications included dural tears in nine patients (20.0%), cerebrospinal fluid leakage in seven patients (15.6%), deep infection in one patient (2.2%), and epidural hematoma in one patient (2.2%). All patients recovered well after treatment. Besides, there was no neurological deterioration and thoracic kyphosis occurred. Conclusions: Zoning laminectomy adopts a phased resection from “safe zone” to “danger zone” and defines the safe removal range of the lamina, which reduces the risks of spinal cord injury caused by instrument manipulation. Therefore, it is a safe and effective surgical option. |
| first_indexed | 2024-04-10T17:48:01Z |
| format | Article |
| id | doaj.art-cf50efc9501445988278463c04502f99 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-04-10T17:48:01Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-cf50efc9501445988278463c04502f992023-02-03T04:55:55ZengElsevierAsian Journal of Surgery1015-95842023-02-01462723729Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavumQiangqiang Pan0Zhenhui Zhang1Yanyu Zhu2Wentao Jiang3Kai Su4Peilin Liu5Yongsheng Kang6Zhe Shao7Wei Mei8Qingde Wang9Henan University, KaiFeng, 475004, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, ChinaDepartment of Spinal Surgery, Zheng Zhou Orthopaedics Hospital, Zhengzhou, China; Corresponding author.Summary: Objective: Spinal cord injury is a common occurrence during spinal surgery. In this study, we proposed a zoning laminectomy, which could reduce the incidence of nerve injury. We also discussed the safety and clinical efficacy of the zoning laminectomy for thoracic ossification of the ligamentum flavum (TOLF). Methods: Forty-five patients with TOLF who underwent zoning laminectomy from October 2016 to February 2020 were included in the retrospective analysis. The Japan Orthopedic Association (JOA) score was used to evaluate clinical outcomes. Meanwhile, the occurrence of complications was recorded. Results: All 45 patients underwent the operation successfully, and the mean follow-up period was 25.3 months, the mean operation time was 160.2 min, the average blood loss was 474.2 ml, and the average hospital time was 8.0 days. At the final evaluation, the JOA score was significantly higher than the preoperative JOA score (P < 0.001) and the overall recovery rate of the JOA score averaged 69.6%. Seventeen patients were graded as excellent, twenty-six as good, and two as fair. The complications included dural tears in nine patients (20.0%), cerebrospinal fluid leakage in seven patients (15.6%), deep infection in one patient (2.2%), and epidural hematoma in one patient (2.2%). All patients recovered well after treatment. Besides, there was no neurological deterioration and thoracic kyphosis occurred. Conclusions: Zoning laminectomy adopts a phased resection from “safe zone” to “danger zone” and defines the safe removal range of the lamina, which reduces the risks of spinal cord injury caused by instrument manipulation. Therefore, it is a safe and effective surgical option.http://www.sciencedirect.com/science/article/pii/S1015958422008594Thoracic myelopathyZoningOssification of ligamentum flavumLaminectomy |
| spellingShingle | Qiangqiang Pan Zhenhui Zhang Yanyu Zhu Wentao Jiang Kai Su Peilin Liu Yongsheng Kang Zhe Shao Wei Mei Qingde Wang Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum Asian Journal of Surgery Thoracic myelopathy Zoning Ossification of ligamentum flavum Laminectomy |
| title | Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum |
| title_full | Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum |
| title_fullStr | Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum |
| title_full_unstemmed | Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum |
| title_short | Zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum |
| title_sort | zoning laminectomy for the treatment of ossification of the thoracic ligamentum flavum |
| topic | Thoracic myelopathy Zoning Ossification of ligamentum flavum Laminectomy |
| url | http://www.sciencedirect.com/science/article/pii/S1015958422008594 |
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