Microchannel-assisted precision surgical treatment for thoracic ossification of the ligamentum flavum: a comparative...

To investigate the clinical efficacy of the microchannel-assisted technique for precise treatment in patients with focal thoracic ossification of the ligamentum flavum.

We retrospectively reviewed the clinical data of 38 patients diagnosed with focal thoracic ossification of the ligamentum flavum (TOLF) who underwent surgical treatment in the Department of Spine Surgery, The Cangzhou Hospital of Integrated TCM-WM Hebei, between January 2018 and December 2022. The patients were divided into two groups according to whether the microchannel-assisted technique was used during surgery: group A (microchannel-assisted group, n = 17) and group B (conventional open surgery group, n = 21). The surgery-related variables, radiological imaging results, and clinical outcomes were compared between the two groups.

None of the patients in either group experienced postoperative neurological deterioration. No statistically significant difference was observed in the JOA score improvement rate at the 2-year follow-up between the two groups (group A: 63.74 ± 18.55, group B: 61.56 ± 17.94, P > 0.05), indicating that the long-term efficacy of the microchannel-assisted technique for TOLF was comparable to that of conventional open surgery. No statistically significant differences were found between group A and group B regarding age, sex, BMI, smoking, alcohol consumption, heart disease, hypertension, and diabetes (P > 0.05). The VAS score for thoracic back pain in group A was superior to that in group B at 1 week and 1 month postoperatively (P < 0.05), but this difference was no longer observed at 3 months postoperatively. Statistically significant differences were observed between the two groups in operative time, blood loss, length of stay, wound length, and time to walking (P < 0.05). No statistically significant differences were found in the remaining relevant variables between the two groups (P > 0.05).

This study confirms that the microchannel-assisted technique is a safe and effective minimally invasive treatment for focal thoracic ossification of the ligamentum flavum. This technique significantly reduces operative time, decreases intraoperative blood loss, promotes postoperative recovery, and lowers complication rates while ensuring comparable long-term neurological outcomes. These advantages are attributed to the concept of "precise decompression" and the preservation of paraspinal muscleoskeletal structures.