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Journal of Korean Neurosurgical Society 2001;30(6): 761-768.
The Analysis on Surgical Result and Prognostic Factors of Thoracic Spinal Stenosis.
Ung Kyu Chang, Sang Kee Chung, Dong Yoon Kim, Chun Kee Chung, Hyun Jib Kim
Department of Neurosurgery, School of Medicine, Seoul National University, Seoul, Korea.
ABSTRACT
OBJECTIVE
To describe the underlying causes, surgical results, and prognostic factors in thoracic stenosis causing myelopathy, retrospective analysis for 28 cases of thoracic stenosis with surgery was performed MATERIALS AND METHOD: Twenty-eight patients(male, 15; female, 13) who underwent decompressive surgery for thoracic stenosis between 1987 and 1997 were analyzed. The mean age was 49 and the mean follow-up was 30.6 months. Statistical analysis with SPSS(r) was performed. Chi-square test was used for the analysis of relationship between subjects and multivariate analysis with general linear model was used to find prognostic factors.
RESULT
Degenerative spondylosis was the most common cause, and three cases were associated with systemic diseases. Decompressive laminectomy was done in 23 cases, anterior decompression in four cases, and combined decompression in one case. Ossification of ligamentum flavum was found in 18 cases, facet hypertrophy in 13, ossification of posterior longitudinal ligament in six, and ventral spur in four. Postoperatively, 16 patients improved functionally and 4 patients worsened. The group of which initial symptom duration was less than two years showed better result(p=0.003). The group with sufficient decompression and no additional proximal stenosis had better outcome(p=0.002, p=0.001).
CONCLUSION
Chronic myelopathy caused by thoracic stenosis can be reversible with appropriate decompression.
Key Words: Thoracic stenosis; Underlying causes; Decompression; Prognostic factors
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