Abstract
The outcome of surgical intervention for thoracic degenerative diseases is generally poor compared with that for cervical or lumbar degenerative diseases, especially in patients with lesions ventral to the thoracic spinal cord. Neurological problems due to thoracic degenerative diseases are uncommon ; large case series reports on surgical treatment of these diseases have been rarely reported. The authors retrospectively analyzed the epidemiology, clinical presentations, surgical approaches, and surgical outcomes in 99 consecutive patients with thoracic degenerative diseases who had undergone surgical treatment in a single institution. Neurological symptoms in these patients were caused by ossification of the ligamentum flavum (OLF) (52 patients) ; intervertebral disc herniation (DH) (19) ; ossification of the posterior longitudinal ligament (OPLL) (7) ; both OLF and DH (13) ; both OLF and OPLL (3) ; or spinal canal stenosis without these entities (5). Patients with thoracic OLF had undergone OLF removal via the posterior approach, and those with DH in the cervicothoracic junction had undergone surgical procedures with the conventional anterior approach. Most patients with middle-to-lower thoracic DH had undergone discectomy via the posterolateral approach, and those with thoracic OPLL had undergone OPLL removal via anterior or anterolateral approaches. Surgical outcomes evaluated using the recovery rate of modified Japanese Orthopaedic Association score showed that all diseases had favorable recovery rate. Surgical complications were found in only a limited number of patients. The authors conclude that the surgical approaches adopted were effective and safe in patients with thoracic degenerative diseases.
