Curative effect and safety of posterolateral approach decompression and discectomy combined with interbody fusion and pedicle screw internal fixation for thoracic spinal stenosis

English Keywords:Thoracic vertebrae  Spinal stenosis  Ossification  Diskectomy

English Abstract:

  【Abstract】 Objectives: To study the efficacy and safety of the posterolateral approach decompression and discectomy combined with interbody fusion and pedicle screw internal fixation for the treatment of the thoracic spinal stenosis. Methods: Twenty two cases with the thoracic spinal stenosis undergoing the posterolateral decompression and discectomy combined with interbody fusion were included in this group. There were 14 males and 8 females. The age ranged from 33 to 69 years old, with an average of 53.5 years. The course of disease ranged from 1 month to 18 months, with an average of 6.7 months. The lesion was T7/8 in 1 case, T8/9 in 4 cases, T9/10 in 9 cases, T10/11 in 8 cases. Frankel grade B was noted in 5 cases, C in 11 cases and D in 6 cases. The clinical results were evaluated by Frankel grade and Otani score system. Results: The operation time was 2.5-5 hours, with an average of 3.2 hours. The blood loss was 400-1800 ml, with an average of 800ml. 20 cases had immediate postoperative neurological improvement. 2 cases, who experienced transient postoperative neurological deterioration, were treated with methylprednisolone, detumescence and nerve nutrition therapy in time, then recovered by degrees at 8 and 24 hours postoperative respectively. The followed-up period was 24 to 60 months(mean, 40 months). At final follow-up, all patients had some extent of neurological improvement, with Frankel grade C in 3 cases, D in 6 cases, E in 13 cases. According to Otani score system, there were excellent in 13 cases and good in 6 cases. The clinical satisfaction rate was 86.36%. All cases reached bony fusion without instrument failure. Conclusions: Posterolateral decompression and discectomy combined with interbody fusion is a safe and effective procedure for the thoracic spinal stenosis.