[Diagnosis and treatment of thoracic myelopathy due to degenerative thoracic spine disease].

OBJECTIVE

To summarize the experience in the early diagnosis and treatment of chronic thoracic myelopathy due to the compression of degenerative thoracic spine disease.

METHODS

21 patients with thoracic spinal stenosis were operated on from January 1995 to April 2000. Etiologically 16 patients were found to have ossification of the ligamentum flovum, 3 Scheuermann's disease, and 2 DISH. They were confirmed by CT, CTM, MRI and Magnetic MEP. Decompression was performed by en block unroof laminectomy for the posterolateral wall of the thoracic canal. The epstein criteria were used to judge the operative results.

RESULTS

In the 21 patients 5 belonged to localized type, 10 continuous type, and 3 skip type in 21 cases. Three patients showed a compression from the anterior side, and 3 were complicated by OPLL of the cervical spine. Results were excellent in 4 patients, good in 8, improved in 2, and poor in 1. One patient was operated on two times because the extent of laminectomy was not enough for the first operation.

CONCLUSIONS

Early diagnosis can be made if orthopedists are familiar with the clinical characteristics of thoracic myelopathy, and are alert to thoracic spine stenosis. En block unroof laminectomy is effective and safe to treat thoracic spine stenosis.