Surgical Treatment of Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine
作者:
Tadashi Kojima,
Shiro Waga,
Yoshichika Kubo,
Toshio Matsubara,
期刊:
Neurosurgery
(OVID Available online 1994)
卷期:
Volume 34,
issue 5
页码: 854-858
ISSN:0148-396X
年代: 1994
出版商: OVID
关键词: Anterior approach;Microsurgery;Myelopathy;Ossification of the posterior longitudinal ligament;Thoracic spine
数据来源: OVID
摘要:
THORACIC OSSIFICATION OF the posterior longitudinal ligament (OPLL) is a rare entity causing thoracic myelopathy. Its surgical decompression is still challenging. Three patients admitted with progressive myelopathy due to thoracic OPLL are described. A transthoracic anterolateral approach was used in the first and second cases, in which OPLL was located at the T3-T4 and T5-T6 and at the T7-T8 levels, respectively. In the third case, a transsternal approach was adopted for OPLL at the T1-T2 level. The OPLL, including dural ossification, was removed by microsurgical techniques as extensively as possible. Myelopathy in all three cases became relieved or stable postoperatively. Operative procedures are described in detail. From the viewpoint of surgical anatomy, the selection of operative approach depends on the level of the OPLL. The authors emphasize that a transthoracic anterolateral approach is the treatment of choice for extensive anterior pathology such as OPLL involving more than two thoracic bodies below the T4. A transsternal approach can provide excellent access to a lesion at the upper three thoracic bodies.
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