Department of Spine Surgery, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China.
Medicine (Baltimore). 2021 May 28;100(21):e26150. doi: 10.1097/MD.0000000000026150.
The thoracic spine is stabilized in the anteroposterior direction by the rib cage and the facet joints, thus thoracic degenerative spondylolisthesis is very uncommon. Here, we report a rare case of thoracic degenerative spondylolisthesis in which the lower thoracic region was the only region involved.
We present the case of a 56-year-old Chinese female who suffered from thoracic degenerative spondylolisthesis. She had a 2-year history of gait disturbance and bilateral lower-extremity numbness. The initial imaging examinations revealed Grade I anterior spondylolisthesis and severe cord compression, as well as bilateral facet joint osteoarthritis at T11/12.
The patient was diagnosed with thoracic degenerative spondylolisthesis-associated myelopathy.
She underwent a posterior decompression with transforaminal thoracic interbody fusion (TTIF) at T11/12.
The patient recovered well after the operation, and MRI at 12-month follow-up revealed that spinal cord compression was relieved and high signal intensity in T2-weighted image was improved.
To the best of our knowledge, this is the first reported case of thoracic degenerative spondylolisthesis in which the lower thoracic region was the only region involved. Disruption of joint capsule, instability with micromotion, and degenerative disc may contribute to this rare disease. Posterior decompression with posterolateral fusion or TTIF were the main treatment modalities, however, TTIF has its unique advantages because of sufficient decompression, immediate stability and high fusion rate.
胸腔脊柱通过胸廓和关节突关节在前后方向上得到稳定，因此胸段退行性脊椎滑脱非常少见。在此，我们报告一例罕见的胸段退行性脊椎滑脱病例，仅累及下胸段。
我们报告了一例 56 岁的中国女性患有胸段退行性脊椎滑脱症的病例。她有 2 年的步态障碍和双侧下肢麻木病史。最初的影像学检查显示 I 度前方脊椎滑脱和严重的脊髓压迫，以及 T11/12 的双侧关节突关节炎。
患者被诊断为胸段退行性脊椎滑脱相关的脊髓病。
她在 T11/12 行后路减压经椎间孔胸腰椎融合术（TTIF）。
患者术后恢复良好，12 个月随访时 MRI 显示脊髓压迫缓解，T2 加权图像高信号强度改善。
据我们所知，这是首例报道的仅累及下胸段的胸段退行性脊椎滑脱病例。关节囊破裂、微运动不稳定和退行性椎间盘可能导致这种罕见疾病。后路减压伴后外侧融合或 TTIF 是主要的治疗方法，但 TTIF 具有独特的优势，因为它可以充分减压、即刻稳定和高融合率。
