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Treatment for Thoracic Ossification of Posterior Longitudinal Ligament with Posterior Circumferential Decompression
- Source :
- Orthopaedic Surgery. 9:206-214
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Objective To report the results of the posterior approach for thoracic ossification of posterior longitudinal ligament (TOPLL) by using a special “L” osteotome. Methods The present study enrolled 16 consecutive patients (9 men and 7 women) between May 2009 and September 2013. All patients underwent a posterior circumferential decompression osteotomy and segmental instrumentation with interbody fusion. The mean age at surgery was 57.3 years (range, 37–68 years). Patients’ data, clinical manifestation, blood loss, length of surgery, complications, visual analog scale (VAS), Japanese Orthopedic Association (JOA), and Frankel grading system before and after surgery were collected and evaluated, retrospectively. Results The average follow-up period was 30 ± 19 months (range, 12–50 months). All patients were successfully treated with posterior compression and segmental instrumentation with interbody fusion. The average operation time was 261.6 ± 51.3 min (range, 190–310 min). The mean blood loss was 980.3 ± 370.5 mL (range, 600–2100 mL). All patients had subjective improvement of motor power and gait. Average preoperative and postoperative JOA scores were 4.2 ± 1.7 and 7.8 ± 2.5 points, respectively. Differences in the overall JOA scores showed significant postoperative improvement. At the last follow-up, all patients improved either by one or two Frankel grades. There was a significant difference between preoperative VAS scores and those 3 months after surgery (P 0.05). Cerebrospinal fluid (CSF) leakage occurred in 3 patients. Acute neurological deterioration was encountered postoperatively in 1 patient. Conclusion Treatment with posterior transpedicular osteotomy and circumferential decompression was found to be safe, effective, reliable, and technically feasible, and keeping the thoracic cavity intact avoids many shortcomings of anterior surgery and results in a satisfactory spinal decompression.
- Subjects :
- medicine.medical_specialty
Decompression
Thoracic cavity
business.industry
medicine.medical_treatment
medicine.disease
Osteotomy
Surgery
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Spinal decompression
Orthopedic surgery
medicine
Internal fixation
Posterior longitudinal ligament
Osteotome
Orthopedics and Sports Medicine
030212 general & internal medicine
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 17577853
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Orthopaedic Surgery
- Accession number :
- edsair.doi...........1812a159623453154e7971621ff7e46f