Transforaminal thoracic interbody fusion : Treatment of thoracic myelopathy caused by anterior compression.

BACKGROUND: The aim of this study was to evaluate the early clinical safety and efficacy of transforaminal thoracic interbody fusion (TTIF) with interbody cage application for thoracic myelopathy caused by anterior compression (TMAC).

METHODS: A total of 10 patients who underwent TTIF for TMAC from July 2009 to July 2014 were retrospectively reviewed. Thoracic spinal lesions included thoracic disc herniation, thoracic ossification of posterior longitudinal ligament, thoracic vertebral compression fracture, and thoracic spine fracture dislocation. Demographic data, radiological findings as well as operative information were collected. Postoperative functional outcomes evaluated by the modified Japanese Orthopedic Association (mJOA) score and complications were analyzed.

RESULTS: The mean operation time was 186.5 min (range 110-315 min), the mean operative blood loss was 845.0 ml (range 400-2000 ml), and the mean recumbent period was 2.7 days (range 1-8 days). During the follow-up period all patients exhibited significant improvements in neurological deficits. The mJOA score improved from a mean of 6.1 ± 1.7 preoperatively to 7.4 ± 1.6 postoperatively and to 9.3 ± 1.6 at final follow-up (P <0.01), with an overall recovery rate of 69.0 ± 26.1%. Solid fusion was observed in all cases. A wound infection was found in one case, in which the patient recovered with no residual neurological deficits after surgical debridement and administration of intravenous antibiotics. No cage-related complications were found in this study.

CONCLUSION: The use of TTIF with cage application can be an effective treatment method of thoracic myelopathy caused by anterior compression, with favorable efficacy and safety.