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Early Treatment for Thoracic Myelopathy Advised

Posted on: 11/30/1999
There are many changes in the spine that occur with aging. Most affect the lower (lumbar) spine. Some affect the neck (cervical) spine. Much less often, but no less disabling, the thoracic spine is affected. The thoracic spine is in the middle between the cervical and lumbar spines. The ribs attach to the thoracic spine.

In this study, the results of surgery for thoracic myelopathy are examined for 132 patients. Myelopathy refers to any problem affecting the spinal cord. In most of these patients, pressure on the spinal cord was caused by changes in the spinal ligaments. These ligaments go along the entire length of the spine. Some patients had disc disease contributing to the problem.

Decompression surgery was done on all patients. This is the removal of bone from around the spinal cord or spinal nerves. Decompression takes the pressure off these nerve tissues. Everyone was tested before and after the surgery. Follow-up was at least two years.

The authors found that 75 per cent of the patients had myelopathy caused by hardening of the posterior longitudinal ligament (PLL). This ligament supports and connects the spine posteriorly (along the back side of the vertebrae).

Most of the patients (87 per cent) had good relief from their symptoms after the operation. The patients who had the best results were those who had symptoms of myelopathy the shortest amount of time.

The results of this study suggest earlier diagnosis and treatment of thoracic myelopathy is important for a good outcome. Recognizing thoracic myelopathy is a challenge. Establishing a correct diagnosis does not always happen until the condition has progressed.Delay in treatment leads to deterioration of the symptoms.

Toshimi Aizawa, MD, PhD, et al. Results of Surgical Treatment for Thoracic Myelopathy: Minimum 2-Year Follow-up Study in 132 Patients. In Journal of Neurosurgery: Spine. July 2007. Vol. 7. No. 1. Pp. 13-20.

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