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
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.
KeywordsSpinal Cord Japanese Orthopaedic Association Japanese Orthopaedic Associa Score Thoracic Level Thoracic Spinal Cord
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