Transient paraparesis after laminectomy for thoracic ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum.
METHODS
Case report.


OBJECTIVE
To report a case with thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF), in which postoperative paralysis occurred after laminectomy and was reversed after an additional posterior instrumented fusion.


METHODS
A University Hospital in Japan.


METHODS
A 71-year-old woman, with a spastic palsy of both lower extremities, had OPLL and OLF at T10-T11, which pinched the spinal cord anteriorly and posteriorly. She underwent a laminectomy at T10-T11, and no further neurological deterioration was seen immediately after surgery. Over the next 18 h, however, myelopathy worsened, showing severe paraparesis. An additional posterior instrumented fusion at T7-L1 was performed without correction of the kyphosis. After fusion, neurological deficits gradually recovered, despite the presence of residual anterior impingement of spinal cord by the OPLL.


CONCLUSIONS
The present case provides evidence for the possibility that laminectomy alone produces postoperative paralysis for combined thoracic OPLL and OLF, and we recommend that a posterior instrumented fusion should be added when posterior decompression is performed for this disorder.
Yamazaki
M
M
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Inohana, Chuo-ku, Chiba, Japan.
Koda
M
M
Okawa
A
A
Aiba
A
A
D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D017843:Ligamentum Flavum / Q000601:surgery*; D017846:Longitudinal Ligaments / Q000601:surgery*; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000601:surgery; D009999:Ossification, Heterotopic / Q000150:complications / Q000601:surgery*; D020335:Paraparesis / Q000209:etiology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome