Long-term follow-up study of anterior decompression and fusion for thoracic myelopathy resulting from ossification of the posterior longitudinal ligament

Yoshikazu Fujimura, Yukimi Nishi, Masaya Nakamura, Yoshiaki Toyama, Nobumasa Suzuki

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Study Design. This was a retrospective study of the results of anterior decompression and fusion in patients with thoracic myelopathy secondary to ossification of the posterior longitudinal ligament with a minimum follow-up time of 5 years. Objectives. To clarify the effectiveness and limits of anterior decompression and fusion for thoracic ossification of the posterior longitudinal ligament. Summary of Background Data. Posterior decompression for the surgical management of thoracic ossification of the posterior longitudinal ligament has had an uncertain success record. Anterior decompression and fusion have been considered the treatment of choice; however, there are few reports describing the long-term results. Methods. The participants in this investigation were 33 patients whose cases were followed for an average period of 8 years and 2 months. The factors that were investigated included changes in the Japanese Orthopedic Association score and in recovery rates, postoperative complications, and radiographic findings of bone union and progression of ossification of the posterior longitudinal ligament within the area of anterior decompression. Results. Although the recovery rates were relatively stable from 1-5 years after surgery, the rates declined thereafter. The average recovery rate at the final follow-up visit was 53.2%. Postoperative complications included three cases of deterioration of thoracic myelopathy and four cases of extrapleural cerebrospinal fluid leakage. Except for the one case of deterioration of thoracic myelopathy, the remainder of the complications were transient. Conclusions. Anterior decompression and fusion is an effective surgical procedure for thoracic ossification of the posterior longitudinal ligament with good, stable, long- term results; when thoracic ossification of the posterior longitudinal ligament was extensive or coincident with ossification of the intraspinal ligament, however, the results were not as predictable.

Original languageEnglish
Pages (from-to)305-311
Number of pages7
JournalSpine
Volume22
Issue number3
DOIs
Publication statusPublished - 1997 Feb 1

Fingerprint

Ossification of Posterior Longitudinal Ligament
Spinal Cord Diseases
Decompression
Thorax
Thoracic Surgical Procedures
Surgical Decompression
Ligaments
Osteogenesis
Orthopedics
Retrospective Studies
Bone and Bones

Keywords

  • anterior decompression and fusion
  • extrapleural approach
  • manubrium splitting approach
  • myelopathy
  • ossification of the posterior longitudinal ligament
  • thoracic spine

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Long-term follow-up study of anterior decompression and fusion for thoracic myelopathy resulting from ossification of the posterior longitudinal ligament. / Fujimura, Yoshikazu; Nishi, Yukimi; Nakamura, Masaya; Toyama, Yoshiaki; Suzuki, Nobumasa.

In: Spine, Vol. 22, No. 3, 01.02.1997, p. 305-311.

Research output: Contribution to journalArticle

Fujimura, Yoshikazu ; Nishi, Yukimi ; Nakamura, Masaya ; Toyama, Yoshiaki ; Suzuki, Nobumasa. / Long-term follow-up study of anterior decompression and fusion for thoracic myelopathy resulting from ossification of the posterior longitudinal ligament. In: Spine. 1997 ; Vol. 22, No. 3. pp. 305-311.
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