Abstract
INTRODUCTION: Ossification of the ligamentum flavum (OLF) is a well-recognised cause of thoracic myelopathy in East Asian countries like Japan and China. T10 and T11 are the most frequently involved segments in the thoracic spine. Initial clinical features are numbness in lower limbs, loss of vibration, and proprioception, as severity increases spastic paraparesis ensues. In this study, the authors retrospectively analysed the clinical outcomes after decompressive laminectomy for thoracic myelopathy due to OLF at the thoracic spine. MATERIALS AND METHODS: This was a retrospective study conducted in the Department of Orthopaedics, in the author's tertiary institute, using medical records from January 2020 to May 2023, after obtaining informed consent from patients and institutional ethics committee approval. Fourteen cases diagnosed with thoracic myelopathy meeting the inclusion criteria and underwent decompressive laminectomy, with at least one year of follow-up, were considered in the study. Demographic data, detailed history of patient's symptoms and duration of symptoms, preoperative and postoperative neurological status, in the form of Japanese Orthopaedic Association (JOA) score, Hirabayashi recovery rate, and Visual Analogue Scale (VAS) score for pain or numbness, were evaluated. RESULTS: Mean operation time was 75.71 ± 28.58 min, and mean blood loss was 166.42 ± 44.99 mL. The mean preoperative JOA score was 4.71 ± 1.43 points which significantly improved to 7.50 ± 2.06 points postoperatively (P < 0.001). The mean Hirabayashi recovery rate was 48.25% (range 12.5-80%). The surgical outcome was excellent in three patients, good in five patients, fair in five patients, and unchanged in one patient. CONCLUSION: Decompressive laminectomy is a safe and effective treatment for thoracic myelopathy due to OLF, which provides satisfactory clinical outcomes improvement.