Abstract
Introduction: The rate of postoperative neurological deterioration is reportedly high in patients with thoracic ossification of posterior longitudinal ligament (T-OPLL). However, the neurological deterioration details after anterior decompression through a posterior approach are unknown.
Methods: In total, 24 patients with T-OPLL (14 males and 10 females; mean age 49 years), who underwent anterior decompression through a posterior approach, were included. The rate of neurological deterioration, timing of occurrence, reoperation, and time required for recovery were investigated. Patients were divided into two groups according to the occurrence of postoperative neurological deterioration, and the following factors were compared: corresponding spinal level, body mass index, duration of disease, preoperative JOA score, morphological type of OPLL, coexisting ossification ligamentum flavum, ossification-kyphosis angle, canal occupancy ratio, thoracic kyphosis, kyphosis correction angle, MEP derivation, number of laminectomy, number of pediculecutomy, dural tear, operative duration, and blood loss.
Results: Postoperative neurological deterioration occurred immediately after the surgery in 4 patients (16.7%). No patient underwent reoperation, and muscle strength recovered within 12 weeks. Those with neurological deterioration had low preoperative JOA scores (p = 0.02), a large number of laminectomy (p = 0.002), and long operative duration (p = 0.005).
Conclusions: The rate of postoperative neurological deterioration was lower than that previously reported. Prolonged compression to the spinal cord, which increased in the prone position, presumably caused neurological deterioration.
