2000 Volume 49 Issue 4 Pages 1147-1150
A fifty-four-year-old man complained of dysbasia with exacerbating numbness of the abdomen and lower extremities, but no subjective symptoms of the upper extremities. On physical examinations, gait was spastic, and sensory disturbance was found in the same lesion as numbness, but motor loss was not found, reflex of lower extremities were hyper-reflexia and Babinski's reflex was observed. The JOA score of the thoracic myelopathy was 7.0 per 11.0 full points.
Mixed type ossification of the posterior longitudinal ligament (OPLL) from C5 to Th7 was found on plain roentgenograms and tomograms. About 60% severe spinal canal stenosis of C7/Th1 and Th2/3 was observed on CT and MRI, suggesting myelopathy accounts for the spinal canal stenosis due to C7/Th1 or Th2/3 OPLL.
We performed Crutchfield skull traction to minimize the dynamic factor of myelopathy. An improvement of the subjective symptoms was observed after five days of traction, suggesting it may be effective for improving symptoms. Therefore, we performed an anterior interbody fusion of only C6/7 and C7/Th1 but not Th2/3. Numbness and spastic gait were cured after the operation. Three years after the operation, the patient was able to walk more than 5km. The JOA score improved from 7.0 to 9.5 points.
