Tohoku J. Exp. Med., 2006, 210(3)

Thoracic Myelopathy in Japan: Epidemiological Retrospective Study in Miyagi Prefecture during 15 Years

TOSHIMI AIZAWA, TETSURO SATO,¹ YASUHISA TANAKA, HIROSHI OZAWA, TAKESHI HOSHIKAWA, YUSHIN ISHII,² NAOKI MOROZUMI,² KENTARO ISHIBASHI,³ FUMIO KASAMA,⁴ HIRONORI HYODO,¹ EIICHI MURAKAMI,⁵ TAKESHI NISHIHIRA⁶ and SHOICHI KOKUBUN

Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan ¹Department of Orthopedic Surgery, Sendai Orthopedic Hospital, Sendai, Japan ²Department of Orthopedic Surgery, Nishitaga National Hospital, Sendai, Japan ³Department of Orthopedic Surgery, Sendai Medical Center, Sendai, Japan ⁴Department of Orthopedic Surgery, Tohoku Rosai Hospital, Sendai, Japan ⁵Department of Orthopedic Surgery, Sendai Social Insurance Hospital, Sendai, Japan, and ⁶Department of Orthopedic Surgery, JR Sendai Hospital, Sendai, Japan

Thoracic myelopathy is defined as spinal cord compression in the thoracic region, leading to sensory and motor dysfunctions in the trunk and lower extremities, and can be caused by various degenerative processes of the spine. Thoracic myelopathy is rare, and there are many unsolved problems including its epidemiological and clinical features. We have established a registration system of spinal surgeries, which covered almost all surgeries in Miyagi Prefecture, and enrolled the data of 265 patients with thoracic myelopathy from 1988 to 2002. The annual rate of surgery gradually increased and averaged 0.9 per 100,000 inhabitants, which was less than 1/10 of that for cervical myelopathy. About 20 patients with thoracic myelopathy are operated on in Miyagi Prefecture each year. It frequently develops in middle-aged males. About half of the cases were caused by ossification of the ligamentum flavum, followed by ossification of the posterior longitudinal ligament, intervertebral disc herniation and posterior spur. Patients usually noticed numbness or pain in the legs and the preoperative duration was long, averaging 2 years. Its symptomatic similarities to lumbar disorders might cause difficulty in making a correct diagnosis. Since thoracic myelopathy can markedly restrict the activities of daily life, even general physicians should recognize this entity.

keywords —— thoracic myelopathy; epidemiological study; ossification of the ligamentum flavum; ossification of the posterior longitudinal ligament

© 2006 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2006, 210, 199-208

Correspondence: Toshimi Aizawa, M.D., Ph.D., 1-1, Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.

e-mail: toshi-7@ra2.so-net.ne.jp