Transforaminal En Bloc Resection for the Treatment of Thoracic Ossification of the Ligamentum Flavum: Retrospective Cohort Study

Background: Our purpose is to introduce transforaminal en bloc resection for the treatment of thoracic ossification of ligamentum flavum, and report outcomes of the procedure.

Patients And Methods: The record of patients with symptomatic thoracic ossification of the ligamentum flavum who received transforaminal en block resection from October 2010 to September 2014 were retrospectively reviewed. Outcomes were Japanese Orthopaedic Association (JOA) lower extremity motor dysfunction and sphincter dysfunction scores.

Results: Seventeen patients (10 males, 7 females) with a median age of 60 years were included in the analysis. Surgery was performed as planned without complications in all patients. One segment decompression was performed in 1 case, 2 segment in 9 cases, 3 segment in 3 cases, and 4 segment in 4 cases. The median lower extremity motor dysfunction score was significantly higher at 2 weeks, 3 months, and 6 months postoperatively, and the end of follow-up, than before surgery (median score: 2, 2, 3, 3, respective, vs. 1, all, p ≤ 0.008). There were no significant differences in JOA sphincter dysfunction score between the different time points.

Conclusion: Transforaminal en bloc resection is a safe and effective method for the treatment of thoracic ossification of the ligamentum flavum.