Surgical treatment for thoracic spinal stenosis

English Keywords:Thoracic cannal stenosis  Surgery  Laminectomy  Efficacy

English Abstract:

  【Abstract】 Objective：To investigate the short-term clinical efficacy of different surgical approaches for thoracic spinal canal stenosis.Method：21 cases with thoracic spinal canal stenosis were treated surgically in our hospital from March 2003 to Jun 2009.Posterior laminectomy was performed in 16 cases，anterior subtotal corpectomy together with auto-graft fusion and fixation through extrapleural and/or retroperitoneal approach was performed in 4 cases，anterior approach transthoracically in 1 case.The complications，Frankel grade，JOA score and Cobb angle of kyphosis were measured at 2 weeks postoperatively and final followed up respectively.Result：The average operation time was 156min with blood loss of 280ml and no intraoperative vascular complications.Postoperative complications occurred in 6 cases，including cerebrospinal fluid leakage in 2 cases，nerve root injury combined with cerebrospinal fluid leakage in 1 case，epidural hematoma in 1 case，temporary neurological deficit in 2 cases，all recovered after effective intervention.All cases were followed up for a mean of 21 months（range，6-75 months）.Compared with preoperation，improvement of Frankel grade was noted in 10 cases and the rest 11 cases still remained no change two weeks after operation whereas improvement occurred in 13 cases and no change in 8 cases at final follow-up.The mean preoperative JOA score improved at 2 weeks after operation and till the final followed up（P<0.05），with the average recovery rate of 42.8% and 63.1% at 2 weeks and final follow-up respectively.The excellent and good rate was 28.6% and 71.4% at 2 weeks and final follow-up respectively.Both were noted to have the effective rates of 85.8%.Compared with preoperation，multi-segment laminectomy tended to have Cobb degree increased more（P<0.05）.Conclusion：Surgical treatments especially posterior decompressive laminectomy shows a good clinical outcome for thoracic spinal stenosis.However，the incidence of surgical related complications is still high and posterior multi-segment laminectomy can notably result in increasing of kyphosis.