Surgical Treatment in myelopathy due to Ossified Posterior Longitudinal Ligament at Both Cervical and Thoracic Region

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Several cases with ossification of the posterior longitudinal ligament at the cervical spine have recently been reported to be associated with ossification of either the posterior longitudinal ligament, the yellow ligaments or both at the thoracic spine. The problem that arises from these is which the main lesion for myelopathy is, cervical or thoracic. This is to report our own experiences of 13 cases which were felt somewhat difficult to determine the main lesion. Careful neurological examinations in the upper and the lower limbs were the most valuable for the diagnosis. When the upper limbs are severely affected or nearly same as the lower limbs are, the main lesion is, in high possibility, located at cervical region. If the lower limbs are more severely affected than the upper limbs, thoracic region could be the main lesion.Cervical laminectomy showed satisfactory results. Whereas thoracic laminectomy did not bring good results, anterior body fusion of the thoracic spine brought better results in thoracic myelopathy due to ossified posterior longitudinal ligament. However, good results were obtained by thoracic laminectomy in cases with thoracic myelopathy due to ossified yellow ligaments.
西日本整形・災害外科学会の論文