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KMID : 0377220080330040015
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Medical Journal of Chosun Univercity
2008 Volume.33 No. 4 p.15 ~ p.19
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Symptomatic Myelopathy caused by Ossification of the Yellow Ligament
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Lee Seung-Myung
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Abstract
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Objectives: This study was performed to de-scribe the clinical presentation, surgical out-come in patients with symptomatic myelo-pathy caused by ossification of the yellow ligament (OYL).
Method: The authors reviewed consequent 12 patients in whom posterior decompressive laminectomy were performed for OYL from 1999 to 2005. A retrospective study of the patients, including 4 men and 8 women was conducted. Diagnostic imagings including simple radiographs, computed tomography (CT) and magnetic resonance images (MRI) were performed in every case. The patients were reviewed to evaluate the clinical presentation, surgical outcome and complications of the operation.
Results: In all patients, OYL was located in the lower thoracic region and all patients presented with lower limb numbness and pain. Among them, 5 patients presented with gait disturbance due to paraparesis and two patients had sphincter dysfunction. Decompressive laminectomy through a posterior approach using microscope resulted in improvement of symptoms in all patients, but, recovery was incomplete in a half of the patients. The mean postoperative Japanese orthopaedics association (JOA) score was 7.9 when com-pared with 4.9 in preoperative assessment and the mean recovery rate was 65%. Dural tear was noticed in four patients, so dural repair was performed, but there was no operative mortality.
Conclusion: OYL is an uncommon cause of myelopathy but it can lead to debili-tating thoracic myelopathy. Careful decom-pressive laminectomy can achieve favorable results
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KEYWORD
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Ossification of yellow ligament, Decompressive laminectomy
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