Posterior Decompression and Fixation for Thoracic Spine Ossification: A 10-Year Follow-Up Study

被引:2
作者
Maruyama, Juntaro [1 ]
Furuya, Takeo [1 ]
Maki, Satoshi [1 ]
Inoue, Takaki [1 ]
Yunde, Atsushi [1 ]
Miura, Masataka [1 ]
Shiratani, Yuki [1 ]
Nagashima, Yuki [1 ]
Shiga, Yasuhiro [1 ]
Inage, Kazuhide [1 ]
Eguchi, Yawara [1 ]
Orita, Sumihisa [1 ,2 ]
Takahashi, Hiroshi [3 ]
Koda, Masao [3 ]
Yamazaki, Masashi [3 ]
Ohtori, Seiji [1 ]
Korovessis, Panagiotis
机构
[1] Chiba Univ, Grad Sch Med, Dept Orthoped Surg, Chiba 2608677, Japan
[2] Chiba Univ, Ctr Frontier Med Engn, Chiba 2638522, Japan
[3] Univ Tsukuba, Grad Sch Comprehens Human Sci, Dept Orthoped Surg, Tsukuba 3058577, Japan
关键词
ossification of the posterior longitudinal ligament; posterior decompression with instrumented fusion; thoracic spine; long-term outcomes; kyphotic angle; additional surgery; patient follow-up; LONGITUDINAL LIGAMENT OPLL; LONG-TERM OUTCOMES; POSTOPERATIVE PROGRESSION; MYELOPATHY; FUSION; SURGERY;
D O I
10.3390/jcm12175701
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Ossification of the posterior longitudinal ligament of the thoracic spine (T-OPLL) causes symptoms including leg and back pain, and motor and sensory deficits. This study retrospectively reviewed 32 patients who initially underwent posterior decompression with instrumented fusion (PDF) for T-OPLL between 2001 and 2012, with 20 qualifying for the final analysis after applying exclusion criteria. Exclusions included unknown preoperative neurological findings, follow-up less than 10 years, or prior spinal surgeries at other levels. Outcomes were assessed using the Japanese Orthopedic Association (JOA) score, recovery rate, and kyphotic angle. The average preoperative JOA score of 3.6 improved to 7.4 at 1 year post-surgery and remained at 7.4 at 10 years, with a recovery rate of 52%. The kyphotic angle at T4-12 increased from 26 degrees preoperatively to 29 degrees postoperatively and to 37 degrees at 10 years. At the fused levels, the angle remained at 26 degrees immediately post-operation and increased to 32 degrees at 10 years. Forty percent of patients required additional surgery, primarily for conditions related to cervical OPLL, such as myelopathy, or lumbar OPLL, such as radiculopathy, or cauda equina syndrome. In conclusion, PDF effectively reduces T-OPLL symptoms over the long term, but the high rate of additional surgeries calls for careful patient follow-up.
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页数:12
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