Diagnosis and Management of Thoracic Myelopathy.

IF 2.6 2区 医学 Q1 ORTHOPEDICS Journal of the American Academy of Orthopaedic Surgeons Pub Date : 2024-09-15 Epub Date: 2024-05-10 DOI:10.5435/JAAOS-D-23-00984
Stephen D Lockey, Julio J Jauregui, Daniel L Cavanaugh, Eugene Y Koh, Francis H T Shen, Steven C Ludwig, Amit S Ratanpal, Anthony K Chiu
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Abstract

Thoracic myelopathy can be a challenging condition to diagnose and treat. Successful outcomes depend on early recondition of the pathology and appropriate surgical referral in cases of progressive neurologic deterioration. The thoracic cord is tethered in kyphosis by the dentate ligaments and contains a tenuous blood supply. These conditions make the thoracic cord particularly susceptible to external compression and ischemic damage. Careful preoperative planning with specific attention to the location and source of thoracic stenosis is critical to successful decompression and complication avoidance. The purpose of this discussion is to outline the common sources of thoracic myelopathy and current recommendations regarding diagnosis and management. The review concludes with an overview of the most up-to-date literature regarding clinical outcomes.

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胸椎脊髓病的诊断和治疗。
胸椎脊髓病的诊断和治疗具有一定的挑战性。成功的治疗取决于病理的早期修复,以及在神经系统逐渐恶化的情况下进行适当的手术转诊。胸脊髓在脊柱后凸时被齿状韧带拴住,血液供应也很脆弱。这些条件使得胸脊髓特别容易受到外部压迫和缺血性损伤。谨慎的术前规划,特别注意胸椎狭窄的位置和来源,是成功减压和避免并发症的关键。本讨论的目的是概述胸椎脊髓病的常见来源以及当前的诊断和管理建议。综述最后概述了有关临床结果的最新文献。
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来源期刊
CiteScore
6.10
自引率
6.20%
发文量
529
审稿时长
4-8 weeks
期刊介绍: The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues. Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.
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Understanding the Influence of Single Payer Health Insurance on Socioeconomic Disparities in Total Hip Arthroplasty (THA) Utilization: A Transnational Analysis. Patellofemoral Instability Part II: Surgical Treatment. American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary Management of Osteoarthritis of the Hip. Femoral Head Fractures: Evaluation, Management, and Outcomes. Trends in Preoperative Outcome Measures From 2013 to 2021 in Patients Undergoing Primary Total Joint Arthroplasty.
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