Transpedicular osteotomy en bloc lamina resection for the treatment of thoracic spinal stenosis

王歡 (Wang Huan，Dept Spine Traum Surg，Shengjing Hosp China Med Univ，Shengyang 110004)…∥Chin J Orthop.－2010，30(11).－1035～1038

Transpedicular osteotomy en bloc lamina resection for the treatment of thoracic spinal stenosis

王歡 (Wang Huan，Dept Spine Traum Surg，Shengjing Hosp China Med Univ，Shengyang 110004)…∥Chin J Orthop.－2010，30(11).－1035～1038

ObjectiveTo study the safety and efficacy of transpedicular osteotomy en bloc lamina resection to treat thoracic spinal stenosis.MethodsA retrospective study of 23 consecutive patients underwent transpedicular osteotomy en bloc lamina resection from June 2004 to December 2008，including 12 males and 11 females，with a mean age of 46 years(range，38 － 62 years)was conducted.The courses of diseases were 1.5 to 20 months with an average of 6.5 months.There were 18 cases caused by thoracic ossification of ligamentum flavum(OLF)，4 cases caused by ossification of posterior longitudinal ligament(OPLL)and 1 case caused chondroma.Preoperative CT and MRI examinations showed that all patients got spinal cord compression.Preoperative ASIA Grade was A for 1 case，B for 3 cases，C for 7 cases and D for 13 cases.Postoperative neurological status was evaluated by ASIA grade system.ResultsThe postoperative follow-up duration rangedfrom 16 to58 months(mean 30 months).The operation time varied from 90 to 210 min，with the average of 163 min.Blood loss varied from 600 to 3200 mL，with the average of 2150 mL.Pedicle screws were used in 10 cases with T9-T12 stenosis，and dura excisions were repaired by lumbodorsal fascia in 5 cases.Cerebrospinal fluid leakage occurred in 2 cases.Postoperative ASIA grade showed that there was A for 1 case，B for 2 cases，C for 2 cases，D for 5 cases and E for 13 cases.ConclusionTranspedicular osteotomy is a good approach，which avoid sclerotic cortex and ossified ligamentum flavum，and resect en bloc lamina with shorter operative time and less blood loss.12 refs，1 fig，1 tab.

(Authors)