Surgical strategy to dural ossification of thoracic spinal stenosis

孫景城(Sun Jingcheg，Dept Or- thop Surg，Gen Hosp，Tianjin Med Univ，Tianjin 300052)…∥Chin J Orthop.－2010，31(1).－39～43

Surgical strategy to dural ossification of thoracic spinal stenosis

孫景城(Sun Jingcheg，Dept Or- thop Surg，Gen Hosp，Tianjin Med Univ，Tianjin 300052)…∥Chin J Orthop.－2010，31(1).－39～43

ObjectiveTo explore the surgical strategies of thoracic spinal stenosis with dural ossification.MethodsOne-hundred and eight patients with thoracic spinal stenosis were treated.Dural ossification was found in 29 cases during operation from January 2004 to June 2008.There were 19 males and 10 females，with an average age of 56.4 years(42 －74 years).The course of disease was 13 months(2 －48months).The lesion was located in T1-T4in 4 cases，T5-T8in 5 cases，and T9-T12in 20 cases.All the patients were treated by posterior lamina resection.Both ossificated dural and ossificated yellow ligament were resected in 16 patients.Decompression was performed with partial ossification remaining on dural surface in 13 cases.JOA score was used to evaluate the outcomes 1，3 and 12 months after operation.ResultsThe average operation time was 140 min，and average bleeding was 300 mL.Dural incisions were repaired with a wound drainage in 11 cases.Seven cases appeared cerebrospinal fluid leakage which healed in 3 －5 days.Dural incisions were not repaired without wound drainage in 5 cases.Cerebrospinal fluid leakage occurred in these cases healed in 5 － 7 days.Thirteen cases treated with floating method did not appear cerebrospinal fluid leakage.All patients did not undergo subarachnoid infection and the aggravation of original nervous system symptoms.According to JOA score，all patients were evaluated as excellent in 22 cases，good in 5 and fair in 2 cases，and excellent and good rate was 93%.ConclusionFor thoracic spinal stenosis with dural ossification，resection of both ossificated dural and ossificated yellow ligament and complete decompression with partial ossification remaining on dural surface is safe and reliable.Dural ossification does not influence the prognosis，but increase operative difficulty and risk.11 refs，8 figs，3 tabs.

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