Abstract
Conservative treatment for patients with ossification of the posterior longitudinal ligament (OPLL) of the thoracic spine is often ineffective, requiring operative treatment for most patients after the conservative treatment. However, conventional operative procedure has high risks for the patients, and clinical results are not satisfactory. In this paper, we undertook a combined method of extensive cervicothoracic laminoplastic decompression and posterior spinal fusion at the thoracic spine, and reported the clinical outcomes of the procedure in three patients (1 man, 2 women, mean age 62.3 years). The follow-up periods ranged from 6 to 15 months (mean 12.0 months). The rates of narrowing measured by computed myelography in the spinal canal were 44% at the Th4/5 level, 56% at the Th2 level and 43% at the C7/Th1. The mean Japanese Orthopaedic Association (JOA) score for cervical myelopathy in the three cases improved from 10.7 points (range 7.5-13.0) to 12.3 points (range 8.5-16.0). However, kyphosis at the fusion segment did not progress after the surgery. Furthermore, a temporary C5 paralysis occurred in two cases, but the patients had fully recovered by the time of the final follow-up examination. We concluded that a combined method of extensive cervicothoracic laminoplastic decompression and posterior spinal fusion at the thoracic spine was useful for prevention of the progressive kyphosis and the posterior decompression of the spinal cord.
