title: Outcomes of fusion surgery for ossification of the posterior longitudinal ligament of the thoracic spine: a multicenter retrospective survey: clinical article.
abstract: OBJECTIVE
  The aim of this study was to evaluate the outcomes of fusion surgery in patients with ossification of the posterior longitudinal ligament in the thoracic spine (T-OPLL) and to identify factors significantly related to surgical outcomes.
  
  
  METHODS
  The study included 76 patients (34 men and 42 women with a mean age of 56.3 years) who underwent fusion surgery for T-OPLL at 7 spine centers during the 5-year period from 2003 to 2007. The authors evaluated the patient demographic data, underlying disease, preoperative comorbidities, history of spinal surgery, radiological findings, surgical methods, surgical outcomes, and complications. Surgical outcomes were assessed using the Japanese Orthopaedic Association (JOA) scale score for thoracic myelopathy (11 points) and the recovery rate.
  
  
  RESULTS
  The mean JOA scale score was 4.6 ± 2.1 points preoperatively and 7.7 ± 2.5 points at the time of the final follow-up examination, yielding a mean recovery rate of 45.4% ± 39.1%. The recovery rates by surgical method were 38.5% ± 37.8% for posterior decompression and fusion, 65.0% ± 35.6% for anterior decompression and fusion via an anterior approach, 28.8% ± 41.2% for anterior decompression via a posterior approach, and 57.5% ± 41.1% for circumferential decompression and fusion. The recovery rate was significantly higher in patients without diabetes mellitus (DM) than in those with DM. One or more complications were experienced by 31 patients (40.8%), including 20 patients with postoperative neurological deterioration, 7 with dural tears, 5 with epidural hematomas, 4 with respiratory complications, and 10 with other complications.
  
  
  CONCLUSIONS
  The outcomes of fusion surgery for T-OPLL were favorable. The absence of DM correlated with better outcomes. However, a high rate of complications was associated with the fusion surgery.
authors: Department of Orthopedic Surgery, Keio University, Japan. morio@sc.itc.keio.ac.jp
authors: Morio
authors: M
authors: Matsumoto
authors: Yoshiaki
authors: Y
authors: Toyama
authors: Hirotaka
authors: H
authors: Chikuda
authors: Katsushi
authors: K
authors: Takeshita
authors: Tsuyoshi
authors: T
authors: Kato
authors: Shigeo
authors: S
authors: Shindo
authors: Kuniyoshi
authors: K
authors: Abumi
authors: Masahiko
authors: M
authors: Takahata
authors: Yutaka
authors: Y
authors: Nohara
authors: Hiroshi
authors: H
authors: Taneichi
authors: Katsuro
authors: K
authors: Tomita
authors: Norio
authors: N
authors: Kawahara
authors: Shiro
authors: S
authors: Imagama
authors: Yukihiro
authors: Y
authors: Matsuyama
authors: Masashi
authors: M
authors: Yamazaki
authors: Akihiko
authors: A
authors: Okawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome