Overview
Thoracic myelopathy results from compression of the spinal cord within the thoracic region, often due to degenerative changes such as spondylolisthesis, disk degeneration, and facet joint arthrosis, leading to neurological deficits and functional impairment 1.Diagnosis
Clinical Presentation: Back pain, radiculopathy, and motor deficits (e.g., weakness in lower extremities) 1.
Imaging Studies:
- MRI: Reveals high signal intensity on T2-weighted images and cord compression 1.
- CT/X-ray: Identifies structural abnormalities like degenerative spondylolisthesis, scoliosis, and facet arthrosis 1.
Neurological Examination: Assesses motor strength (e.g., grading of hip flexion and knee extension) 1.Management
Surgical Intervention:
- Total Laminectomy and Posterior Instrumented Fusion: Indicated for severe cases with significant cord compression 1.
Non-Surgical Management: Not detailed in the provided abstract; typically includes conservative measures like physical therapy and pain management 1.Special Populations
Elderly: Surgical outcomes can vary; careful assessment of comorbidities and functional status is crucial 1.
Comorbidities: Presence of conditions like cerebral palsy may influence preoperative status and postoperative recovery 1.Key Recommendations
Imaging with MRI is essential for confirming thoracic myelopathy and assessing cord compression (Evidence: Moderate 1).
Surgical decompression and stabilization (e.g., laminectomy with fusion) should be considered for severe cases with significant neurological deficits (Evidence: Weak 1).
Comprehensive preoperative evaluation is necessary, especially in elderly patients or those with comorbidities, to optimize surgical outcomes (Evidence: Expert opinion 1).References
1 Kim HJ, Suk SI, Chang DG. Thoracic Myelopathy Caused by Thoracic Degenerative Spondylolisthesis and Lumbar Scoliosis. Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews 2025. link