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Two-staged decompression for thoracic paraparesis due to the combined ossification of the posterior longitudinal ligament and the ligamentum flavum: a case report.
Arch Orthop Trauma Surg 2008; 128(2):175-7AO

Abstract

STUDY DESIGN

A case report of ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the ligamentum flavum, or yellow ligament (OYL), in the upper thoracic spine.

OBJECTIVE

To describe a rare clinical entity and its management pitfalls in a patient with upper thoracic myelopathy due to combined OPLL and OYL.

METHODS

A 52-year-old woman developed paresthesia and paraparesis of both legs. One month prior to admission she fell and became unable to walk. She was diagnosed as having upper thoracic myelopathy due to combined OPLL and OYL and was treated by two-stage anterior and posterior spinal decompression. Posterior decompression was achieved first by laminoplasty at C3-Th1 and laminectomy of Th2 and Th3.

RESULTS

After posterior decompression, her symptoms immediately and dramatically improved. However, symptoms recurred after she was able to achieve a sitting or standing position. We then performed anterior decompression at Th2, which again improved her symptoms. At two years post-surgery, she is ambulatory with the use of a cane.

CONCLUSION

Upper thoracic myelopathy due to OPLL and OYL was treated by combined 2-staged anterior and posterior decompression. In this case, posterior decompression alone was inadequate to relieve the symptoms of this pathological condition.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Gifu University School of Medicine, 1-1Yanagido, Gifu City, Gifu-Prefecture 501-1194, Japan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17497161

Citation

Hioki, Akira, et al. "Two-staged Decompression for Thoracic Paraparesis Due to the Combined Ossification of the Posterior Longitudinal Ligament and the Ligamentum Flavum: a Case Report." Archives of Orthopaedic and Trauma Surgery, vol. 128, no. 2, 2008, pp. 175-7.
Hioki A, Miyamoto K, Hosoe H, et al. Two-staged decompression for thoracic paraparesis due to the combined ossification of the posterior longitudinal ligament and the ligamentum flavum: a case report. Arch Orthop Trauma Surg. 2008;128(2):175-7.
Hioki, A., Miyamoto, K., Hosoe, H., & Shimizu, K. (2008). Two-staged decompression for thoracic paraparesis due to the combined ossification of the posterior longitudinal ligament and the ligamentum flavum: a case report. Archives of Orthopaedic and Trauma Surgery, 128(2), pp. 175-7.
Hioki A, et al. Two-staged Decompression for Thoracic Paraparesis Due to the Combined Ossification of the Posterior Longitudinal Ligament and the Ligamentum Flavum: a Case Report. Arch Orthop Trauma Surg. 2008;128(2):175-7. PubMed PMID: 17497161.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two-staged decompression for thoracic paraparesis due to the combined ossification of the posterior longitudinal ligament and the ligamentum flavum: a case report. AU - Hioki,Akira, AU - Miyamoto,Kei, AU - Hosoe,Hideo, AU - Shimizu,Katsuji, Y1 - 2007/05/12/ PY - 2006/10/16/received PY - 2007/5/15/pubmed PY - 2008/6/28/medline PY - 2007/5/15/entrez SP - 175 EP - 7 JF - Archives of orthopaedic and trauma surgery JO - Arch Orthop Trauma Surg VL - 128 IS - 2 N2 - STUDY DESIGN: A case report of ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the ligamentum flavum, or yellow ligament (OYL), in the upper thoracic spine. OBJECTIVE: To describe a rare clinical entity and its management pitfalls in a patient with upper thoracic myelopathy due to combined OPLL and OYL. METHODS: A 52-year-old woman developed paresthesia and paraparesis of both legs. One month prior to admission she fell and became unable to walk. She was diagnosed as having upper thoracic myelopathy due to combined OPLL and OYL and was treated by two-stage anterior and posterior spinal decompression. Posterior decompression was achieved first by laminoplasty at C3-Th1 and laminectomy of Th2 and Th3. RESULTS: After posterior decompression, her symptoms immediately and dramatically improved. However, symptoms recurred after she was able to achieve a sitting or standing position. We then performed anterior decompression at Th2, which again improved her symptoms. At two years post-surgery, she is ambulatory with the use of a cane. CONCLUSION: Upper thoracic myelopathy due to OPLL and OYL was treated by combined 2-staged anterior and posterior decompression. In this case, posterior decompression alone was inadequate to relieve the symptoms of this pathological condition. SN - 0936-8051 UR - https://www.unboundmedicine.com/medline/citation/17497161/Two_staged_decompression_for_thoracic_paraparesis_due_to_the_combined_ossification_of_the_posterior_longitudinal_ligament_and_the_ligamentum_flavum:_a_case_report_ L2 - https://dx.doi.org/10.1007/s00402-007-0336-5 DB - PRIME DP - Unbound Medicine ER -