Journal of Korean Neurosurgical Society

  • 제47권1호
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  • Pages.55-57
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  • 2010
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Late Occurrence of Cervicothoracic Ossification of Posterior Longitudinal Ligaments in a Surgically Treated Thoracic OPLL Patient

  • Hyun, Seung-Jae (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Jong-Soo (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hong, Seung-Chyul (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 발행 : 2010.01.28
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초록

Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine is rare, even in the Far East. A 45-year-old female presented with a 4month history of progressive motor weakness in the lower extremities, numbness below the midthoracic area, and spastic gait disturbance. Neuroradiological examinations revealed massive OPLLs at the T4-T6 levels with severe anterior compression of the spinal cord. Anterior decompressive corpectomies with bone grafts were performed from T4 to T6 using a trans-thoracic approach. After surgery, the patient made an uneventful recovery. However, eleven years after surgery, the patient developed recurrent lower extremity weakness and spastic gait disturbance. De novo OPLLs at the C6-T2 levels were responsible for the severe spinal cord compression on this occasion. After second surgery, paralysis in both legs was resolved. We present a rare case of late cervicothoracic OPLL in a patient surgically treated for thoracic OPLL.

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참고문헌

  1. Bohlman HH, Zdeblick TA : Anterior excision of herniated thoracic discs. J Bone Joint Surg 70 : 1038-1047, 1988
  2. Dohn DF : Thoracic spinal cord decompression : Alternative surgical approaches and basis of choice. Clin Neurosurg 27 : 611-623, 1980
  3. Epstein N : Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament. Spine J 2 : 436-449, 2002 https://doi.org/10.1016/S1529-9430(02)00394-7
  4. Hanai K, Ogikubo O, Miyashita T : Anterior decompression for myelopathy resulting from thoracic ossification of the posterior longitudinal ligament. Spine 15 : 1070-1076, 2002
  5. Inamasu J, Guiot BH, Sachs DC : Ossification of the posterior longitudinal ligament : an update on its biology, epidemiology, and natural history. Neurosurgery 58 : 1027-1039; discussion 1027-1039, 2006 https://doi.org/10.1227/01.NEU.0000215867.87770.73
  6. Japanese Orthopedic Association : Scoring system for cervical myelopathy. J Jpn Orthop Assoc 68 : 490-503, 1994
  7. Kojima T, Waga S, Kubo Y, Matsubara T : Surgical treatment of ossification of the posterior longitudinal ligament in the thoracic spine. Neurosurgery 34 : 854-858; discussion 858, 1994 https://doi.org/10.1227/00006123-199405000-00010
  8. Lim CS, Cho TH, Park JY, Park YK, Suh JK, Lee HK : Thoracic myelopathy caused by multiple ossified ligamentum flavum combined with ossification of the posterior longitudinal ligament : Case Report. J Korean Neurosurg Soc 25 : 617-621, 1996
  9. Micheli LJ, Hood RW : Anterior exposure of the cervicothoracic spine using a combined cervical and thoracic approach. J Bone Joint Surg 65 : 992-997, 1983
  10. Ogawa Y, Toyama Y, Chiba K, Matsumoto M, Nakamura M, Takaishi H, et al. : Long-term results of expansive opendoor laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine. J Neurosurg Spine 1 : 168-174, 2004 https://doi.org/10.3171/spi.2004.1.2.0168
  11. Park JY, Chin DK, Kim KS, Cho YE : Thoracic ligament ossification in patients with cervical ossification of the posterior longitudinal ligaments: tandem ossification in the cervical and thoracic spine. Spine 33 : E407-E410, 2008 https://doi.org/10.1097/BRS.0b013e318175c276
  12. Stillerman CB, Weiss MH : Management of thoracic disc disease. Clin Neurosurg 38 : 325-352, 1992
  13. Sundaresan N, Shah J, Feghali JG : A transsternal approach to the upper thoracic vertebrae. Am J Surg 148 : 473-477, 1984 https://doi.org/10.1016/0002-9610(84)90372-6
  14. Vasudevan A, Knuckey NW : Ossification of the ligamentum flavum. J Clin Neurosci 9 : 311-313, 2002 https://doi.org/10.1054/jocn.2001.0962
  15. Yamamoto I, Matsumae M, Ikeda A, Shibuya N, Sato O, Nakamura K : Thoracic spinal stenosis : Experience with seven cases. J Neurosurg 68 : 37-40, 1988 https://doi.org/10.3171/jns.1988.68.1.0037
  16. Yonenobu K, Ebara S, Fujiwara K, Yamashita K, Ono K, Yamamoto T, et al. : Thoracic myelopathy secondary to ossification of the spinal ligament. J Neurosurg 66 : 511-518, 1987 https://doi.org/10.3171/jns.1987.66.4.0511

피인용 문헌

  1. Single-stage combined decompression for patients with tandem ossification in the cervical and thoracic spine vol.132, pp.9, 2012, https://doi.org/10.1007/s00402-012-1540-5
  2. Posterior Trans-Dural Repair of Iatrogenic Spinal Cord Herniation after Resection of Ossification of Posterior Longitudinal Ligament vol.10, pp.2, 2016, https://doi.org/10.4184/asj.2016.10.2.355
  3. Surgical Outcomes According to Dekyphosis in Patients with Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine vol.63, pp.1, 2010, https://doi.org/10.3340/jkns.2018.0177