title: Mid- to long-term outcomes of posterior decompression with instrumented fusion for thoracic ossification of the posterior longitudinal ligament.
abstract: Posterior decompression with instrumented fusion (PDF) surgery has been previously reported as a relatively safe surgical procedure for any type of thoracic ossification of the longitudinal ligament (OPLL). However, mid- to long-term outcomes are still unclear. The aim of the present study was to elucidate the mid- to long-term clinical outcome of PDF surgery for thoracic OPLL patients. The present study included 20 patients who had undergone PDF for thoracic OPLL and were followed for at least 5years. Increment change and recovery rate of the Japanese Orthopaedic Association (JOA) score were assessed. Revision surgery during the follow-up period was also recorded. Average JOA scores were 3.5 preoperatively and 7.1 at final follow-up. The average improvement in JOA score was 3.8 points and the average recovery rate was 47.0%. The JOA score showed gradual increase after surgery, and took 9months to reach peak recovery. As for neurological complications, two patients suffered postoperative paralysis, but both recovered without intervention. Six revision surgeries in four patients were related to OPLL. Additional anterior thoracic decompression for remaining ossification at the same level of PDF surgery was performed in one patient. Decompression surgery for deterioration of symptoms of pre-existing cervical OPLL was performed in three patients. One patient had undergone lumbar and cervical PDF surgery for de novo ossification foci of the lumbar and cervical spine. PDF surgery for thoracic OPLL is thus considered a relatively safe and stable surgical procedure considering the mid- to long-term outcomes.
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan. Electronic address: masaokod@gmail.com.
authors.forename: Masao
authors.initials: M
authors.lastname: Koda
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Furuya
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okawa
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Taigo
authors.initials: T
authors.lastname: Inada
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Koshiro
authors.initials: K
authors.lastname: Kamiya
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Ota
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Maki
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Orthopedic Surgery, University of Tsukuba, Tsukuba, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Aramomi
authors.affiliation: Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ikeda
authors.affiliation: Department of Orthopedic Surgery, Chiba Aoba Municipal Hospital, Chiba, Japan.
authors.forename: Chikato
authors.initials: C
authors.lastname: Mannoji
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017846:Longitudinal Ligaments / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000601:surgery*; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome
keywords: Ossification of the posterior longitudinal ligament; Posterior fusion; Thoracic spine