Circumspinal Decompression With Dekyphosis Stabilization for Thoracic Myelopathy due to Ossification of the Posterior Longitudinal Ligament

Kawahara, Norio; Tomita, Katsuro; Murakami, Hideki; Hato, Taizo; Demura, Satoru; Sekino, Yoichi; Nasu, Wataru; Fujimaki, Yoshiyasu

doi:10.1097/brs.0b013e31815e3911

Cited by 79 publications

(70 citation statements)

References 14 publications

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“…We have employed the same concepts in planning PDF as we use in planning circumspinal decompression [6,15]. We explained to patients that PDF was the first operation and that we could add OPLL extirpation via thoracotomy as the second operation if their neurological recovery after PDF was insufficient.…”

Section: Indication Of Additional Opll Extirpationmentioning

confidence: 99%

“…We explained to patients that PDF was the first operation and that we could add OPLL extirpation via thoracotomy as the second operation if their neurological recovery after PDF was insufficient. At our institute, the informed consent procedure for patients undergoing the first operation included our presenting all the information we had about the advantages and the disadvantages of additional OPLL extirpation surgery, including the high neurological recovery rate in successful cases of OPLL extirpation as well as the attendant risk of postoperative deterioration [6,13,18]. The choice of adding a second surgery was then left to the patient.…”

Section: Indication Of Additional Opll Extirpationmentioning

confidence: 99%

“…Surgeons have employed a variety of surgical procedures to treat thoracic OPLL, including laminectomy [5], OPLL extirpation through thoracotomy [2,4,10], OPLL extirpation through a posterior approach [13], and circumspinal decompression [6,15]. However, postoperative paraplegia remains a major risk [2, 4, 8-10, 13, 15].…”

Section: Introductionmentioning

confidence: 99%

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Posterior decompression with instrumented fusion for thoracic myelopathy caused by ossification of the posterior longitudinal ligament

et al. 2010

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We evaluated the clinical results of posterior decompression with instrumented fusion (PDF) for thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL). A total of 24 patients underwent PDF, and their surgical outcomes were evaluated by the Japanese Orthopaedic Association (JOA) scores (0-11 points) and by recovery rates calculated at 3, 6, 9 and 12 months after surgery and at a mean final follow-up of 4 years and 5 months. The mean JOA score before surgery was 3.7 points. Although transient paralysis occurred immediately after surgery in one patient (3.8%), all patients showed neurological recovery at the final follow-up with a mean JOA score of 8.0 points and a mean recovery rate of 58.1%. The mean recovery rate at 3, 6, 9 and 12 months after surgery was 36.7, 48.8, 54.0 and 56.8%, respectively. The median time point that the JOA score reached its peak value was 9 months after surgery. No patient chose additional anterior decompression surgery via thoracotomy. The present findings demonstrate that despite persistent anterior impingement of the spinal cord by residual OPLL, PDF can result in considerable neurological recovery with a low risk of postoperative paralysis. Since neurological recovery progresses slowly after PDF, we suggest that additional anterior decompression surgery is not desirable during the early stage of recovery.

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Section: Indication Of Additional Opll Extirpationmentioning

confidence: 99%

Section: Indication Of Additional Opll Extirpationmentioning

confidence: 99%

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Posterior decompression with instrumented fusion for thoracic myelopathy caused by ossification of the posterior longitudinal ligament

et al. 2010

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“…16,29,35,36,38 It is thought that posterior stabilization reduces the compressive forces of the OPLL plaque on the spinal cord. 11,16 It also allows for stabilization during anterior decompression. 11 Anterior decompression for OPLL of the thoracic spine may be accomplished via an anterior (manubrium splitting), posterior (transpedicular, costotransversectomy, or lateral extracavitary), or lateral approach (thoracotomy).…”

Section: Advantages and Disadvantages With Indications And Limitationmentioning

confidence: 99%

“…11,16 It also allows for stabilization during anterior decompression. 11 Anterior decompression for OPLL of the thoracic spine may be accomplished via an anterior (manubrium splitting), posterior (transpedicular, costotransversectomy, or lateral extracavitary), or lateral approach (thoracotomy). The transthoracic extrapleural or transpleural approaches can successfully approach the anterior column via a lateral approach.…”

Section: Advantages and Disadvantages With Indications And Limitationmentioning

confidence: 99%

Management of ossification of the posterior longitudinal ligament of the thoracic spine

McClendon

Sugrue

Ganju

et al. 2011

FOC

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The management of thoracic ossification of the posterior longitudinal ligament has been studied by many spinal surgeons. Indications for operative intervention include progressive radiculopathy, myelopathy, and neurological deterioration. The ideal surgery for decompression remains highly debatable as various methods of surgical treatment of ossification of the posterior longitudinal ligament have been devised. Although numerous modifications to the 3 main approaches have been identified (anterior, posterior, or lateral), the indication for each depends on the nature of compression, the morphology of the lesion, the level of the compression, the structural alignment of the spine, and the neurological status of the patient. The authors discuss treatment techniques for thoracic ossification of the posterior longitudinal ligament, cite case examples from a single institution, and review the literature.

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Thoracic Degenerative Conditions

Adenwalla

Badejo²,

Larsen³

et al. 2022

Multidisciplinary Spine Care

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Circumspinal Decompression With Dekyphosis Stabilization for Thoracic Myelopathy due to Ossification of the Posterior Longitudinal Ligament

Abstract: The OPLL plaque in the thoracic spine might be most easily, safely, and completely removed or floated, and the spinal cord is circumferentially decompressed through circumspinal decompression with dekyphosis stabilization.

Cited by 79 publications

References 14 publications

Posterior decompression with instrumented fusion for thoracic myelopathy caused by ossification of the posterior longitudinal ligament

Posterior decompression with instrumented fusion for thoracic myelopathy caused by ossification of the posterior longitudinal ligament

Management of ossification of the posterior longitudinal ligament of the thoracic spine

Thoracic Degenerative Conditions

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