Skip to main content

Extensive Cervicothoracic Laminoplastic Decompression of the Spinal Cord: A New Method of Posterior Decompression for Thoracic Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament

  • Chapter
Book cover OPLL

Abstract

Ossification of the posterior longitudinal ligament (OPLL) at the thoracic level tends to be multiple or extensive, depending on the degree and number of impingements on the spinal cord. In the case of thoracic myelopathy caused by OPLL, excision of OPLL is the most effective method of relieving pressure on the spinal cord, but the anterior approach for OPLL excision is technically demanding. Moreover, in the case of highly impinging OPLL, postoperative neurological deterioration resulting in complete paraplegia, although infrequent, has been reported [1-3]. So far, thoracic OPLL has remained a challenge to the spinal surgeon in Japan. Postoperative neurological catastrophes are thought to arise from inadvertent trauma of the spinal cord, resulting from the excision maneuvers in an OPLL-narrowed spinal canal. Moreover, the spinal cord has probably lost its vital resistance to trauma following severe and long-standing compression by OPLL.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Fujimura Y, Asazuma K, Toyama Y, Suzuki N, Hirabayashi K (1995) Results of anterior decompression and fusion for 13. thoracic myelopathy. J Jpn Spine Res Soc 6: 228

    Google Scholar 

  2. Ohtsuka K, Nakakohji T, Matsuda S, Kamimura M, Ashizawa R (1995) Results of anterior decompression of spinal cord through posterior approach for thoracic myelopathy. J Jpn Spine Res Soc 6: 23

    Google Scholar 

  3. Yonenobu K, Ebara S, Fujiwara K, Yamashita K, Ono K, Yamamoto T, Harada N, Ogino H, Ojima S (1987) Thoracic myelopathy secondary to ossification of the spinal ligament. J Neurosurg 66: 511–518

    Article  PubMed  CAS  Google Scholar 

  4. Tsuzuki N, Abe R, Saiki K, Kondo T, Wadano Y, Kikuchi S (1993) Extensive cervicothoracic laminoplastic decompression for the thoracic myelopathy due to OPLL. Rinsho Seikeigeka (Clin Orthop Surg) 28: 303–311

    Google Scholar 

  5. Seki S, Kikuchi S (1995) Short term outcome of the extensive cervicothoracic laminoplastic decompression for the cervical and thoracic myelopathy due to OPLL. J Jpn Spine Res Soc 6: 45

    Google Scholar 

  6. Wadano Y, Hirabayashi H, Aida I, Kanaoka K, Fujisaki Y, Hayashi K, Tsuzuki N, Abe R (1995) Extensive laminoplastic decompression for the thoracic myelopathy. J Jpn Spine Res Soc 6: 66

    Google Scholar 

  7. Tsuzuki N, Abe R, Kusakabe N, Okai K (1991) Tension-banded enlarged laminoplasty of the cervical spine. East Jpn J Clin Orthop 3: 654–663

    Google Scholar 

  8. Tsuzuki N (1995) Tension-band laminoplasty. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques, vol 2. Saunders, Philadelphia, pp 1825–1827

    Google Scholar 

  9. Ohtsuka K, Terayama K, Wada M, Kinoshita H, Takahashi S, Murata S (1988) The results of surgical treatment for thoracic myelopathy due to ossification of the posterior longitudinal ligament—anterior decompression of the thoracic cord through the posterior approach. Rinsho Seikeigeka (Clin Orthop Surg) 23: 467–472

    Google Scholar 

  10. Tsuzuki N, Tanaka H, Seichi A (1989) Laminopediculoplasty: a new method of reconstruction of the posterior elements of the thoracic spine. Int Orthop (SICOT) 13: 39–45

    Article  CAS  Google Scholar 

  11. Tsuzuki N, Kostuik J (1996) Laminoplasty of the thoracic and lumbar spine. In: Frymoyer JW, Ducker TB, Hadler NM, Kostuik JP, Weinstein JN, Whitecloud TS III (eds) The adult spine, principles and practice (2nd edn). Lippincott-Raven, Philadelphia (in press)

    Google Scholar 

  12. Miura S, Inahata Y, Komagata M, Tanaka M, Kawai K, Shiotsu T (1992) Clinical study of thoracic spinal cord compression due to ossification of the spinal ligaments. In: Investigation committee report on the ossification of the spinal ligaments of the Japanese Ministry of Public Health and Welfare. Annual report of 1991, pp 328–331

    Google Scholar 

  13. Tsuzuki N, Abe R, Saiki K, Li Zhongshi (1996) Extradural tethering effect as one mechanism of radiculopathy complicating posterior decompression of the cervical spinal cord. Spine 21: 203–211

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Japan

About this chapter

Cite this chapter

Tsuzuki, N., Wadano, Y., Kikuchi, Si. (1997). Extensive Cervicothoracic Laminoplastic Decompression of the Spinal Cord: A New Method of Posterior Decompression for Thoracic Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament. In: Yonenobu, K., Sakou, T., Ono, K. (eds) OPLL. Springer, Tokyo. https://doi.org/10.1007/978-4-431-67046-9_22

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-67046-9_22

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-67048-3

  • Online ISBN: 978-4-431-67046-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics