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Thoracic spondylotic myelopathy in diffuse idiopathic skeletal hyperostosis: a comparative study
YuLei Dong1, Jiahao Li1, Kaili Yang2
1Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan Dongdan, Dongcheng District, Beijing, 100730, People's Republic of China.
Journal of Orthopaedic Surgery and Research
|March 25, 2023
Summary
Thoracic spinal stenosis with diffuse idiopathic skeletal hyperostosis (DISH) affects more males with higher BMI. Surgery yields similar outcomes for DISH and non-DISH patients, though DISH may require staged procedures.
Area of Science:
- Spine surgery
- Orthopedics
- Degenerative spine disease
Background:
- Diffuse idiopathic skeletal hyperostosis (DISH) is a spinal condition.
- Thoracic spinal stenosis presents unique diagnostic and management challenges.
Purpose of the Study:
- To investigate the characteristics of thoracic spinal stenosis in patients with DISH.
- To compare clinical management and outcomes between DISH and non-DISH patients undergoing surgery.
Main Methods:
- Retrospective analysis of 100 patients with thoracic spondylotic myelopathy undergoing surgery.
- Classification into DISH and non-DISH groups.
- Comparison of demographic, radiographic, and clinical parameters.
Main Results:
- DISH patients were more frequently male and had higher BMI.
- Increased incidence of ossification of posterior longitudinal ligament (OPLL) and ossification of ligamentum flavum (OLF) in DISH group.
- No significant differences in surgical bleeding, CSF leakage, or JOA scores.
Conclusions:
- Thoracic spinal stenosis with DISH is associated with male gender and higher BMI.
- Posterior decompression and fusion surgery provide comparable outcomes for DISH and non-DISH patients.
- DISH may necessitate staged surgery due to associated OPLL and OLF.
