Artikel
Treatment of 64 patients with degenerative thoracic myelopathy – a single center retrospective case series
Behandlungsmanagement der thorakalen Myelopathie – eine retrospektive Single Center Fallserie
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Veröffentlicht: | 8. Mai 2019 |
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Objective: Thoracic myelopathy (TM) as a result of spinal degeneration is rare and rarely diagnosed. Larger case series have not been published yet. Neurosurgical intervention is indicated to prevent neurologic deterioration and allow recovery of neurologic deficits.
Methods: In a retrospective study, we screened our surgically treated patients over the last ten years (Dec. 2007–Dec. 2017) with TM caused by disc herniation and/or spinal canal stenosis of the thoracolumbar spine (from Th1/2 to L1/2). 64 patients could be included (24 female, 40 male), median age 68.5 years ±13.8. 32 patients showed bladder and bowel dysfunction.
Results: 31 patients underwent dorsal stabilization and decompression because of degenerative instability, 30 patients a posterior decompression and in three patients a percutaneous sequestrectomy was performed. 46 patients (72%) had a postoperative improvement of their neurological functions and 12 patients (19%) were stable. A deterioration of neurological functions was seen in 6 patients (9%).
Conclusion: Our case series shows that neurosurgical intervention in TM is mandatory and allows a recovery of neurologic functions in 72% of our patients.