Abstract
Ossification of posterior longitudinal ligament (OPLL) is known to occur well in the cervical spine, but it can also occur in the thoracic spine. OPLL in thoracic spine is usually progressive. So conservative treatment is usually unfavorable and surgical treatment is often needed. Several surgical techniques have been reported within categories of anterior and posterior approach but standard protocols for thoracic OPLL have not been established. Anterior decompression is an ideal method for complete removal of thoracic OPLL but this surgical approach requires high technical skills and use fusion techniques with bone graft implantation or spinal instrumentation. So mini-thoracotomy technique of anterior approach without fusion or instrumentation is devised and the result of this technique is favorable. This mini-thoracotomy and transthoracic anterior decompression technique have several benefits. It needs small skin incision and both bone graft implantation and spinal instrumentation are not needed. So the recovery periods of patients after the surgery is short.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Imagama S, Ando K, Takeuchi K, Kato S, Murakami H, Aizawa T, et al. Perioperative complications after surgery for thoracic ossification of posterior longitudinal ligament: a nationwide multicenter prospective study. Spine. 2018;43:E1389–97.
Tsuyama N. Ossification of the posterior longitudinal ligament of the spine. Clin Orthop Relat Res. 1984;71–84.
Ido K, Shimizu K, Nakayama Y, Yamamuro T, Shikata J, Matsushita M, et al. Anterior decompression and fusion for ossification of posterior longitudinal ligament in the thoracic spine. J Spinal Disord. 1995;8:317–23.
Kim SY, Hyun S-J, Kim K-J, Jahng T-A. Surgical outcomes according to dekyphosis in patients with ossification of the posterior longitudinal ligament in the thoracic spine. J Korean Neurosurg Soc. 2020;63(1):89–98.
Hanakita J. Microsurgery for thoracic OPLL: assessing direct visualization and safe removability of the ossified lesion ([日本脊椎脊髄病学会 特集号] 第 39 回日本脊椎脊髄病学会 英文抄録集). J Spine Res. 2011;2:244–7.
Kanematsu R, Hanakita J, Takahashi T, Tomita Y, Minami M. Microsurgical resection of ossification of the posterior longitudinal ligament in the thoracic spine via the transthoracic approach without spinal fusion: case series and technical note. J Neurosurg Spine. 2019;1:1–8.
Fujimura Y, Nishi Y, Nakamura M, Toyama Y, Suzuki N. Anterior decompression and fusion for ossification of the posterior longitudinal ligament of the upper thoracic spine causing myelopathy: using the manubrium splitting approach. Spinal Cord. 1996;34:387.
Kurosa Y, Yamaura I, Nakai O, Shinomiya K. Selecting a surgical method for thoracic myelopathy caused by ossification of the posterior longitudinal ligament. Spine. 1996;21:1458–66.
Fujimura Y, Nishi Y, Nakamura M, Toyama Y, Suzuki N. Long-term follow-up study of anterior decompression and fusion for thoracic myelopathy resulting from ossification of the posterior longitudinal ligament. Spine. 1997;22:305–11.
Fujimura Y, Nishi Y, Nakamura M, Watanabe M, Matsumoto M. Myelopathy secondary to ossification of the posterior longitudinal ligament of the thoracic spine treated by anterior decompression and bony fusion. Spinal Cord. 1997;35:777.
Min J-H, Jang J-S, Lee S-H. Clinical results of ossification of the posterior longitudinal ligament (OPLL) of the thoracic spine treated by anterior decompression. Clin Spine Surg. 2008;21:116–9.
Matsuyama Y, Sakai Y, Katayama Y, Imagama S, Ito Z, Wakao N, et al. Indirect posterior decompression with corrective fusion for ossification of the posterior longitudinal ligament of the thoracic spine: is it possible to predict the surgical results? Eur Spine J. 2009;18:943–8.
Uei H, Tokuhashi Y, Oshima M, Maseda M, Nakahashi M, Nakayama E. Efficacy of posterior decompression and fixation based on ossification-kyphosis angle criteria for multilevel ossification of the posterior longitudinal ligament in the thoracic spine. J Neurosurg Spine. 2018;29:150–6.
Zhang H-Q, Chen L-Q, Liu S-H, Zhao D, Guo C-F. Posterior decompression with kyphosis correction for thoracic myelopathy due to ossification of the ligamentum flavum and ossification of the posterior longitudinal ligament at the same level. J Neurosurg Spine. 2010;13:116–22.
Matsuyama Y, Yoshihara H, Tsuji T, Sakai Y, Yukawa Y, Nakamura H, et al. Surgical outcome of ossification of the posterior longitudinal ligament (OPLL) of the thoracic spine: implication of the type of ossification and surgical options. Clin Spine Surg. 2005;18:492–7.
Tokuhashi Y, Matsuzaki H, Oda H, Uei H. Effectiveness of posterior decompression for patients with ossification of the posterior longitudinal ligament in the thoracic spine: usefulness of the ossification-kyphosis angle on MRI. Spine. 2006;31:E26–30.
Cho JY, Chan CK, Lee S-H, Choi W-C, Maeng DH, Lee H-Y. Management of cerebrospinal fluid leakage after anterior decompression for ossification of posterior longitudinal ligament in the thoracic spine: the utilization of a volume-controlled pseudomeningocele. Clin Spine Surg. 2012;25:E93–102.
Chin KR, Seale J, Cumming V. “White cord syndrome” of acute tetraplegia after anterior cervical decompression and fusion for chronic spinal cord compression: a case report. Case Rep Orthop. 2013; 2013.
Y-i O, Iwatsuki K, Yoshimura K, Ishihara M, Yoshimine T. Incarcerated herniation of the cervical spinal cord after laminectomy for an ossification of the yellow ligament. Eur Spine J. 2010;19:140–3.
Kumar R, Taha J, Greiner AL. Herniation of the spinal cord: case report. J Neurosurg. 1995;82:131–6.
Ozawa H, Aizawa T, Tateda S, Hashimoto K, Kanno H, Ishizuka M. Spinal cord swelling after surgery in cervical spondylotic myelopathy. Clin Spine Surg. 2018;31:E363–7.
Cheung V, Hoshide R, Bansal V, Kasper E, Chen CC. Methylprednisolone in the management of spinal cord injuries: Lessons from randomized, controlled trials. Surg Neurol Int. 2015;6:142.
Wagner KE, Binyamin TR, Colley P, Chiluwal AK, Harrop JS, Hawryluk GW, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the surgical timing in acute spinal cord injury study (STASCIS). Oper Neurosurg. 2019;17:S45–75.
Nas K, Yazmalar L, Şah V, Aydın A, Öneş K. Rehabilitation of spinal cord injuries. World J Orthop. 2015;6:8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply
About this chapter
Cite this chapter
Ko, S.J., Bae, J., Lee, SH. (2021). Mini-Thoracotomy and OPLL Resection. In: Lee, SH., Bae, J., Jeon, SH. (eds) Minimally Invasive Thoracic Spine Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-15-6615-8_20
Download citation
DOI: https://doi.org/10.1007/978-981-15-6615-8_20
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-6614-1
Online ISBN: 978-981-15-6615-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)