Surgical treatment of thoracic spinal stenosis: A 2- to 9-year follow-up

Mark A. Palumbo, Alan S. Hilibrand, Robert Hart, Henry H. Bohlman

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Study Design. A retrospective investigation of the results of operative treatment of patients with symptomatic thoracic spinal stenosis. Objectives. To establish the effectiveness and define the limitations of surgical treatment for stenosis of the thoracic spinal canal. Summary of Background Data. In contrast to cervical and lumbar stenosis, symptomatic narrowing of the thoracic spinal canal is rarely encountered. Although the treatment of thoracic stenosis has been described in multiple case reports and in several small series with minimal follow-up evaluation, there are few studies of patients treated surgically for this condition with follow-up evaluation beyond 2 years. Methods. Twelve patients who underwent operative decompression for symptomatic stenosis of the lower thoracic spine were followed up for an average period of 62.4 months. Surgery was performed on the thoracic spine alone in four cases and on the combined thoracolumbar spine in eight. Factors that were investigated included pain severity, lower extremity motor function, ambulatory status, and postoperative complications. Results. The level of pain after surgery was decreased in eight patients and unchanged in four patients. Of the 10 patients with a motor deficit before surgery, eight had improvement of muscle function. Of the 11 patients with a gait disturbance before surgery, ambulatory status was improved in seven, unchanged in two, and worse in two. One patient lost neural function secondary to surgical intervention. There were five cases in which the early result subsequently deteriorated because of recurrent stenosis, spinal deformity/instability, or both. Conclusions. Thoracic stenosis can occur in isolation or, more commonly, in association with lumbar stenosis. Ideally, operative treatment should address all stenotic segments and directly decompress the primary anatomic abnormalities causing neural element compression. Although satisfactory short-term results can be expected, deterioration of the early outcome because of the potential for recurrent stenosis and deformity/instability at the thoracolumbar junction can sometimes be seen with longer follow-up evaluation periods.

Original languageEnglish (US)
Pages (from-to)558-566
Number of pages9
JournalSpine
Volume26
Issue number5
DOIs
StatePublished - Mar 1 2001

Fingerprint

Spinal Stenosis
varespladib methyl
Thorax
Pathologic Constriction
Spinal Canal
Spine
Therapeutics
Pain
Decompression
Ambulatory Surgical Procedures
Gait
Lower Extremity
Muscles

Keywords

  • Myelopathy
  • Spinal stenosis
  • Thoracic spine

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Palumbo, M. A., Hilibrand, A. S., Hart, R., & Bohlman, H. H. (2001). Surgical treatment of thoracic spinal stenosis: A 2- to 9-year follow-up. Spine, 26(5), 558-566. https://doi.org/10.1097/00007632-200103010-00021

Surgical treatment of thoracic spinal stenosis : A 2- to 9-year follow-up. / Palumbo, Mark A.; Hilibrand, Alan S.; Hart, Robert; Bohlman, Henry H.

In: Spine, Vol. 26, No. 5, 01.03.2001, p. 558-566.

Research output: Contribution to journalArticle

Palumbo, MA, Hilibrand, AS, Hart, R & Bohlman, HH 2001, 'Surgical treatment of thoracic spinal stenosis: A 2- to 9-year follow-up', Spine, vol. 26, no. 5, pp. 558-566. https://doi.org/10.1097/00007632-200103010-00021
Palumbo, Mark A. ; Hilibrand, Alan S. ; Hart, Robert ; Bohlman, Henry H. / Surgical treatment of thoracic spinal stenosis : A 2- to 9-year follow-up. In: Spine. 2001 ; Vol. 26, No. 5. pp. 558-566.
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N2 - Study Design. A retrospective investigation of the results of operative treatment of patients with symptomatic thoracic spinal stenosis. Objectives. To establish the effectiveness and define the limitations of surgical treatment for stenosis of the thoracic spinal canal. Summary of Background Data. In contrast to cervical and lumbar stenosis, symptomatic narrowing of the thoracic spinal canal is rarely encountered. Although the treatment of thoracic stenosis has been described in multiple case reports and in several small series with minimal follow-up evaluation, there are few studies of patients treated surgically for this condition with follow-up evaluation beyond 2 years. Methods. Twelve patients who underwent operative decompression for symptomatic stenosis of the lower thoracic spine were followed up for an average period of 62.4 months. Surgery was performed on the thoracic spine alone in four cases and on the combined thoracolumbar spine in eight. Factors that were investigated included pain severity, lower extremity motor function, ambulatory status, and postoperative complications. Results. The level of pain after surgery was decreased in eight patients and unchanged in four patients. Of the 10 patients with a motor deficit before surgery, eight had improvement of muscle function. Of the 11 patients with a gait disturbance before surgery, ambulatory status was improved in seven, unchanged in two, and worse in two. One patient lost neural function secondary to surgical intervention. There were five cases in which the early result subsequently deteriorated because of recurrent stenosis, spinal deformity/instability, or both. Conclusions. Thoracic stenosis can occur in isolation or, more commonly, in association with lumbar stenosis. Ideally, operative treatment should address all stenotic segments and directly decompress the primary anatomic abnormalities causing neural element compression. Although satisfactory short-term results can be expected, deterioration of the early outcome because of the potential for recurrent stenosis and deformity/instability at the thoracolumbar junction can sometimes be seen with longer follow-up evaluation periods.

AB - Study Design. A retrospective investigation of the results of operative treatment of patients with symptomatic thoracic spinal stenosis. Objectives. To establish the effectiveness and define the limitations of surgical treatment for stenosis of the thoracic spinal canal. Summary of Background Data. In contrast to cervical and lumbar stenosis, symptomatic narrowing of the thoracic spinal canal is rarely encountered. Although the treatment of thoracic stenosis has been described in multiple case reports and in several small series with minimal follow-up evaluation, there are few studies of patients treated surgically for this condition with follow-up evaluation beyond 2 years. Methods. Twelve patients who underwent operative decompression for symptomatic stenosis of the lower thoracic spine were followed up for an average period of 62.4 months. Surgery was performed on the thoracic spine alone in four cases and on the combined thoracolumbar spine in eight. Factors that were investigated included pain severity, lower extremity motor function, ambulatory status, and postoperative complications. Results. The level of pain after surgery was decreased in eight patients and unchanged in four patients. Of the 10 patients with a motor deficit before surgery, eight had improvement of muscle function. Of the 11 patients with a gait disturbance before surgery, ambulatory status was improved in seven, unchanged in two, and worse in two. One patient lost neural function secondary to surgical intervention. There were five cases in which the early result subsequently deteriorated because of recurrent stenosis, spinal deformity/instability, or both. Conclusions. Thoracic stenosis can occur in isolation or, more commonly, in association with lumbar stenosis. Ideally, operative treatment should address all stenotic segments and directly decompress the primary anatomic abnormalities causing neural element compression. Although satisfactory short-term results can be expected, deterioration of the early outcome because of the potential for recurrent stenosis and deformity/instability at the thoracolumbar junction can sometimes be seen with longer follow-up evaluation periods.

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