OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT OF THE THORACIC SPINE

概要

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I reviewed my own cases with ossification of longitudinal ligament (OPLL) of the thoracic spine and discuss the clinical symptoms, diagnosis and surgical outcomes. Conservative treatments were useless for thoracic myelopathy due to OPLL, and in fact, the neurological status of the patients who took the conservative treatments deteriorated during the conservative treatments. Therefore, early diagnosis is essential and surgical treatment should be considered before the deterioration of neurological status. Because thoracic OPLL sometimes combines with another type of ossification of intraspinal canal such as ossification of yellow ligament (OYL) and multilevel of OPLL, it is important to determine the responsible level of OPLL for the neurological deficit, and to select the surgical procedure based on neurological findings and radiological findings. Anterior decompression and fusion through anterior approach has been considered the reasonable surgical procedure for thoracic OPLL, because of the application of this procedure to any level of thoracic OPLL and the good and stable outcomes of long-term follow-up. However, there is a certain limitation of this procedure for patients with extensive thoracic OPLL or thoracic OPLL combined with OYL. For them, a novel and safer approach and method should be established in the near future.
一般社団法人国立医療学会の論文