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Treatment of Thoracic Myelopathy Secondary to Spondyloarthrosis by Posterior Fusion without Direct Decompression. Case report Takahiro Naruse 1 , Makoto Yanase 2 , Yumiko Horie 2 , Yukihiro Matsuyama 3 1Department of Orthopedic Surgery, Kaikoukai Rehabilitation Hospital 2Department of Orthopedic Surgery, Kaikoukai Nagoya Kyouritsu Hospital 3Department of Orthopedic Surgery, Nagoya University School of Medicine and Graduate School of Medicine Keyword: 胸髄症 , thoracic myelopathy , 後方固定 , posterior fusion , 変形性胸椎症 , thoracic spondyloarthrosis pp.105-110
Published Date 2009/1/25
DOI https://doi.org/10.11477/mf.1408101446
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 Thoracic myelopathy caused by anterior compression of the spinal cord, such as by ossification of the posterior longitudinal ligament (OPLL), has been difficult to treat surgically because of the presence of kyphosis in the thoracic region, and the choice of method of surgical treatment is still a matter of controversy. We report a case of thoracic myelopathy caused by vertebral body osteophytes at the Th7/8 level that was treated by posterior fusion alone, without laminectomy. A 64-year-old male complained of weakness in his legs, a difficulty walking, and urinary incontinence. MRI revealed the presence of small osteophytes secondary to thoracic spondylosis at the Th7/8 level, and we treated the patient by performing Th5-11 posterior fusion by pedicle screw fixation without laminectomy. This procedure achieved immobilization, and the slight reduction in kyphosis in the thoracic region was successful in achieving indirect decompression of the spinal cord and improving the patient's neurological status. The results suggest the effectiveness of immobilization and indirect decompression by reduction of kyphosis without direct decompression for the treatment of anterior compression of the spinal cord in the thoracic region.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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