Comparison of percutaneous endoscopic thoracic decompression and posterior thoracic laminectomy for treating thoracic ossification of the ligamentum flavum: a retrospective study

BACKGROUND: Thoracic spinal stenosis (TSS) caused by ossification of the ligamentum flavum (OLF) is generally treated by surgical decompression. In this study, we compared the efficacy and safety of percutaneous endoscopic thoracic decompression (PETD) and posterior thoracic laminectomy (PTL) for treating thoracic ossification of the ligamentum flavum (TOLF). METHODS: Twenty consecutive patients with TSS caused by TOLF who were treated between April 2016 and May 2020 were included in this retrospective study. They were divided into the PETD (n = 11) and PTL (n = 9) groups. The mean follow-up period was 19.6 months. The visual analogue scale (VAS) score, the modified Japanese Orthopedic Association (mJOA) score and the recovery rate (RR) were used to evaluate the clinical outcomes. RESULTS: There were significant differences between PETD group and PTL group in operative time (min) (95.0 ± 18.8 vs 131.1 ± 19.0), postoperative drainage (mL) (20.2 ± 7.9 vs 586.1 ± 284.2), hospital stay (days) (4.4 ± 1.2 vs 10.4 ± 2.6) (P < 0.05 for all). However, both groups had similar and significant improvement in VAS and mJOA scores. The RR of two groups achieved the same improvement (81.8% VS 77.8%, P > 0.05). CONCLUSIONS: The use of PETD and PTL for treating TOLF both achieved favorable outcomes. PETD is both minimally invasive and achieves similar postoperative symptom relief to PTL. Therefore, PETD could be considered as an effective alternative to traditional open surgery for TOLF in single-segment lower thoracic spine.