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European Spine Journal

Erschienen in:

15.07.2020 | Review Article

The prevalence and clinical characteristics of thoracic spinal stenosis: a systematic review

verfasst von: Guanghui Chen, Tianqi Fan, Xiaoxi Yang, Chuiguo Sun, Dongwei Fan, Zhongqiang Chen

Erschienen in: European Spine Journal | Ausgabe 9/2020

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Abstract

Purpose

Thoracic spinal stenosis (TSS) is a rare disease secondary to multiple pathological changes that differ in prevalence and clinical characteristics. The epidemiological characteristics of these pathologies are largely unknown due to the limited case samples and regional differences. Therefore, a systematic review was conducted to elucidate the prevalence and clinical characteristics of TSS.

Methods

Case series and case reports on the ossification of the posterior longitudinal ligaments (OPLL), ossification of the ligamentum flavum (OLF) and thoracic disk herniation (TDH) were screened from PubMed, Embase and Web of Science databases and systematically reviewed. Epidemiological, demographic and segmental distribution data were extracted and analyzed.

Results

A total of 129 studies including 1935 subjects were selected, of which 361 (18.7%) were diagnosed with OPLL, 804 (41.5%) with OLF, 143 (7.4%) with OPLL + OLF and 627 (32.4%) with TDH. Most reports were from China, Japan and USA. Thoracic OPLL occurred mostly at the middle-thoracic spine (43.4%), while OLF predominately occurred at the lower-thoracic spine (63.1%). TDH was mainly localized in the middle (46.0%) and lower-thoracic (50.3%) spine. Thirty-two studies involving 524 patients described tandem spinal stenosis, of which 52.1% had accompanying cervical diseases and 35.9% lumbar diseases.

Conclusions

There are significant differences in the age, sex and segment distribution characteristics of different pathologies leading to TSS. Tandem spinal stenosis is not uncommon and should be considered when diagnosing TSS. Our findings provide new insights into the prevalence and clinical characteristics of TSS and can help reduce misdiagnosis.

Amato V, Giannachi L, Irace C, Corona C (2012) Thoracic spinal stenosis and myelopathy: report of two rare cases and review of the literature. J Neurosurg Sci 56(4):373–378PubMed

Barnett GH, Hardy RW, Little JR, Bay JW, Sypert GW (1987) Thoracic spinal canal stenosis. J Neurosurg 66(3):338–344PubMed

Dommisse GF (1974) The blood supply of the spinal cord. A critical vascular zone in spinal surgery. J Bone Joint Surg Br Vol B 56(2):225–235

Lazorthes G, Gouaze A, Zadeh JO, Santini JJ, Lazorthes Y, Burdin P (1971) Arterial vascularization of the spinal cord. Recent studies of the anastomotic substitution pathways. J Neurosurg 35(3):253–262PubMed

Li Z, Ren D, Zhao Y, Hou S, Li L, Yu S, Hou T (2016) Clinical characteristics and surgical outcome of thoracic myelopathy caused by ossification of the ligamentum flavum: a retrospective analysis of 85 cases. Spinal Cord 54(3):188–196PubMed

Yu S, Wu D, Li F, Hou T (2013) Surgical results and prognostic factors for thoracic myelopathy caused by ossification of ligamentum flavum: posterior surgery by laminectomy. Acta Neurochir (Wien) 155(7):1169–1177

Aizawa T, Sato T, Sasaki H, Matsumoto F, Morozumi N, Kusakabe T, Itoi E, Kokubun S (2007) Results of surgical treatment for thoracic myelopathy: minimum 2-year follow-up study in 132 patients. J Neurosurg Spine 7(1):13–20PubMed

Garry JP (2018) A rare case of thoracic spinal stenosis in a white male. Current Sports Med Rep 17(1):13–15

Bajwa NS, Toy JO, Ahn NU (2012) Establishment of parameters for congenital thoracic stenosis: a study of 700 postmortem specimens. Clin Orthop Relat Res 470(11):3195–3201PubMedPubMedCentral

10.

Zhu Q, Qian M, Xiao J, Wu Z, Wang Y, Zhang J (2013) Myelopathy due to calcified meningiomas of the thoracic spine: minimum 3-year follow-up after surgical treatment. J Neurosurg Spine 18(5):436–442PubMed

11.

Pettigrew DB, Fessler RD, Farley CW, Al-Nafi S, Holtz JR, Wiebracht ND, Look AC, Kuntz C (2015) Spinal cord intramedullary pressure in thoracic scoliotic deformity: a cadaveric study. Spine 40(4):E242–247PubMed

12.

Takeuchi A, Miyamoto K, Hosoe H, Shimizu K (2004) Thoracic paraplegia due to missed thoracic compressive lesions after lumbar spinal decompression surgery -Report of three cases. J Neurosurg 100(1):71–74PubMed

13.

Onishi E, Yasuda T, Yamamoto H, Iwaki K, Ota S (2016) Outcomes of surgical treatment for thoracic myelopathy: a single-institutional study of 73 patients. Spine (Phila Pa 1976) 41(22):E1356–E1363

14.

Fujimori T, Watabe T, Iwamoto Y, Hamada S, Iwasaki M, Oda T (2016) Prevalence, concomitance, and distribution of ossification of the spinal ligaments: results of whole spine ct scans in 1500 Japanese patients. Spine (Phila Pa 1976) 41(21):1668–1676

15.

Guo JJ, Luk KD, Karppinen J, Yang H, Cheung KM (2010) Prevalence, distribution, and morphology of ossification of the ligamentum flavum: a population study of one thousand seven hundred thirty-six magnetic resonance imaging scans. Spine (Phila Pa 1976) 35(1):51–56

16.

Kudo S, Ono M, Russell WJ (1983) Ossification of thoracic ligamenta flava. Am J Roentgenol 141(1):117–121

17.

Williams DM, Gabrielsen TO, Latack JT, Martel W, Knake JE (1984) Ossification in the cephalic attachment of the ligamentum flavum. An anatomical and CT study. Radiology 150(2):423–426PubMed

18.

Ohtsuka K, Terayama K, Yanagihara M, Wada K, Kasuga K, Machida T, Furukawa K (1986) An epidemiological survey on ossification of ligaments in the cervical and thoracic spine in individuals over 50 years of age. Nihon Seikeigeka Gakkai zasshi 60(11):1087–1098PubMed

19.

Mori K, Imai S, Kasahara T, Nishizawa K, Mimura T, Matsusue Y (2014) Prevalence, distribution, and morphology of thoracic ossification of the posterior longitudinal ligament in Japanese: results of CT-based cross-sectional study. Spine (Phila Pa 1976) 39(5):394–399

20.

Ono M, Russell WJ, Kudo S, Kuroiwa Y, Takamori M, Motomura S et al (1982) Ossification of the thoracic posterior longitudinal ligament in a fixed population. Radiological and neurological manifestations. Radiology 143(2):469–474PubMed

21.

Liang H, Liu G, Lu S, Chen S, Jiang D, Shi H, Fei Q (2019) Epidemiology of ossification of the spinal ligaments and associated factors in the Chinese population: a cross-sectional study of 2000 consecutive individuals. BMC Musculoskelet Disord 20(1):253PubMedPubMedCentral

22.

Arce CA, Dohrmann GJ (1985) Herniated thoracic disks. Neurol Clin 3(2):383–392PubMed

23.

Carson J, Gumpert J, Jefferson A (1971) Diagnosis and treatment of thoracic intervertebral disc protrusions. J Neurol Neurosurg Psychiatry 34(1):68–77PubMedPubMedCentral

24.

Overley SC, Kim JS, Gogel BA, Merrill RK, Hecht AC (2017) Tandem spinal stenosis: a systematic review. JBJS Rev 5(9):e2PubMed

25.

Hou X, Sun C, Liu X, Liu Z, Qi Q, Guo Z, Li W, Zeng Y, Chen Z (2016) Clinical features of thoracic spinal stenosis-associated myelopathy: a retrospective analysis of 427 cases. Clin Spine Surg 29(2):86–89PubMed

26.

Mori K, Kasahara T, Mimura T, Nishizawa K, Murakami Y, Matsusue Y, Imai S (2013) Prevalence, distribution, and morphology of thoracic ossification of the yellow ligament in Japanese: results of CT-based cross-sectional study. Spine (Phila Pa 1976) 38(19):E1216–1222

27.

Moon BJ, Kuh SU, Kim S, Kim KS, Cho YE, Chin DK (2015) Prevalence, distribution, and significance of incidental thoracic ossification of the ligamentum flavum in Korean patients with back or leg pain : mr-based cross sectional study. J Korean Neurosurg Soc 58(2):112–118PubMedPubMedCentral

28.

Moher D, Liberati A, Tetzlaff J, Altman DG, Grp P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ Br Med J 339:7

29.

Kim SI, Ha KY, Lee JW, Kim YH (2018) Prevalence and related clinical factors of thoracic ossification of the ligamentum flavum-a computed tomography-based cross-sectional study. Spine J 18(4):551–557PubMed

30.

Gao R, Yuan W, Yang L, Shi G, Jia L (2013) Clinical features and surgical outcomes of patients with thoracic myelopathy caused by multilevel ossification of the ligamentum flavum. Spine J 13(9):1032–1038PubMed

31.

Nishiura I, Isozumi T, Nishihara K, Handa H, Koyama T (1999) Surgical approach to ossification of the thoracic yellow ligament. Surg Neurol 51(4):368–372PubMed

32.

Aizawa T, Sato T, Tanaka Y, Ozawa H, Hoshikawa T, Ishii Y, Morozumi N, Ishibashi K, Kasama F, Hyodo H, Murakami E, Nishihira T, Kokubun S (2006) Thoracic myelopathy in Japan: epidemiological retrospective study in Miyagi Prefecture during 15 years. Tohoku J Exp Med 210(3):199–208PubMed

33.

He SS, Hussain N, Li SH, Hou TS (2005) Clinical and prognostic analysis of ossified ligamentum flavum in a Chinese population. J Neurosurg Spine 3(5):348–354PubMed

34.

Ben Hamouda K, Jemel H, Haouet S, Khaldi M (2003) Thoracic myelopathy caused by ossification of the ligamentum flavum: a report of 18 cases. J Neurosurg 99(2):157–161PubMed

35.

Pascal-Moussellard H, Cabre P, Smadja D, Catonne Y (2005) Symptomatic ossification of the ligamentum flavum: a clinical series from the French Antilles. Spine 30(14):E400–E405PubMed

36.

Love JG, Schorn VG (1967) Thoracic disk protrusions. Rheumatism 23(1):2–10PubMed

37.

Lang N, Yuan HS, Wang HL, Liao J, Li M, Guo FX, Shi S, Chen ZQ (2013) Epidemiological survey of ossification of the ligamentum flavum in thoracic spine: CT imaging observation of 993 cases. Eur Spine J 22(4):857–862PubMed

38.

Akune T, Ogata N, Seichi A, Ohnishi I, Nakamura K, Kawaguchi H (2001) Insulin secretory response is positively associated with the extent of ossification of the posterior longitudinal ligament of the spine. J bone Joint Surg Am 83(10):1537–1544PubMed

39.

Kobashi G, Washio M, Okamoto K, Sasaki S, Yokoyama T, Miyake Y, Sakamoto N, Ohta K, Inaba Y, Tanaka H (2004) High body mass index after age 20 and diabetes mellitus are independent risk factors for ossification of the posterior longitudinal ligament of the spine in Japanese subjects: a case-control study in multiple hospitals. Spine 29(9):1006–1010PubMed

40.

Shingyouchi Y, Nagahama A, Niida M (1996) Ligamentous ossification of the cervical spine in the late middle-aged Japanese men. Its relation to body mass index and glucose metabolism. Spine 21(21):2474–2478PubMed

41.

Okamoto K, Kobashi G, Washio M, Sasaki S, Yokoyama T, Miyake Y, Sakamoto N, Ohta K, Inaba Y, Tanaka H (2004) Dietary habits and risk of ossification of the posterior longitudinal ligaments of the spine (OPLL); findings from a case-control study in Japan. J Bone Miner Metab 22(6):612–617PubMed

42.

Washio M, Kobashi G, Okamoto K, Sasaki S, Yokoyama T, Miyake Y, Sakamoto N, Ohta K, Inaba Y, Tanaka H (2004) Sleeping habit and other life styles in the prime of life and risk for ossification of the posterior longitudinal ligament of the spine (OPLL): a case-control study in Japan. J Epidemiol 14(5):168–173PubMed

43.

Feng FB, Sun CG, Chen ZQ (2015) Progress on clinical characteristics and identification of location of thoracic ossification of the ligamentum flavum. Orthop Surg 7(2):87–96PubMedPubMedCentral

44.

Takenaka S, Kaito T, Hosono N, Miwa T, Oda T, Okuda S, Yamashita T, Oshima K, Ariga K, Asano M, Fuchiya T, Kuroda Y, Nagamoto Y, Makino T, Yamazaki R, Yonenobu K (2014) Neurological manifestations of thoracic myelopathy. Arch Orthop Trauma Surg 134(7):903–912PubMed

45.

Ojo OA, Kaye AH (2010) An unusual cause of spinal cord compression. J Clin Neurosci 17(1):86, 156.

46.

Giblin EM, Hochheiser GM (2008) Thoracic disk herniation resulting in acutely progressing paraplegia in a pediatric patient. Pediatr Emerg Care 24(8):550–553PubMed

47.

Tsukamoto N, Maeda T, Miura H, Jingushi S, Hosokawa A, Harimaya K, Higaki H, Kurata K, Iwamoto Y (2006) Repetitive tensile stress to rat caudal vertebrae inducing cartilage formation in the spinal ligaments: a possible role of mechanical stress in the development of ossification of the spinal ligaments. J Neurosurg Spine 5(3):234–242PubMed

48.

Kawaguchi Y, Nakano M, Yasuda T, Seki S, Hori T, Kimura T (2013) Ossification of the posterior longitudinal ligament in not only the cervical spine, but also other spinal regions: analysis using multidetector computed tomography of the whole spine. Spine (Phila Pa 1976) 38(23):E1477–1482

Titel: The prevalence and clinical characteristics of thoracic spinal stenosis: a systematic review
verfasst von: Guanghui Chen
Tianqi Fan
Xiaoxi Yang
Chuiguo Sun
Dongwei Fan
Zhongqiang Chen
Publikationsdatum: 15.07.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 9/2020
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-020-06520-6

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