The clinical features and treatment strategies of thoracic ossification of posterior longitudinal liga-ment

孙景城(Sun Jingcheng，Dept Orthop，Gen Hosp，Tianjin Med Univ，Tianjin 300052)…∥Chin J Orthop.－2010，30(11).－1044～1047

The clinical features and treatment strategies of thoracic ossification of posterior longitudinal liga-ment

孙景城(Sun Jingcheng，Dept Orthop，Gen Hosp，Tianjin Med Univ，Tianjin 300052)…∥Chin J Orthop.－2010，30(11).－1044～1047

ObjectiveTo study the clinical features and surgical strategies of thoracic spinal stenosis caused by ossification of posterior longitudinal ligament(OPLL).MethodsFrom January 2004 to March 2009，21 cases of thoracic spinal stenosis casued by OPLL，including 13 males and 8 females，received surgical treatments.Those cases aged from 34 to 71 years，with an average of 51.2 years old.The courses of disease were from 2 to 50 months，averaged 11 months.The lesions located in upper thoracic(T1-T4)for 4 cases，in middle thoracic(T5-T8)for 7 cases，in lower thoracic(T9-T12)for 10 cases.Nine cases were associated with ossification of ligamentum flavum(OLF)，and 8 cases combined with cervical OPLL.Eleven cases received laminectomy and 10 cases received anterolateral decompression.ResultsThe operation time was 90 to 240 min for posterior laminectomy with an average of 140 min，and 110 to 360 min for anterolateral decompression with an average of 240 min.All cases had no worse postoperative symptoms，neurological complications，subarachnoid cavity or wound infection.Japanese Orthopaedic Association(JOA)score was 8 to 15 with an average of 9.17 ± 1.63 in 6 months after surgery.Nerve function improvement was excellent for 8 cases，good for 6 cases，fair for 5 cases and poor for 2 cases.The excellent and good rate was 66.7%.JOA score was 8 － 15，averaged 10.23 ±1.64，in 12 months after surgery.Nerve function improvement was excellent for 8 cases，good for 7 cases，fair for 4 cases，and poor for 2 cases.The excellent and good rate was 71.4%.ConclusionThoracic spinal stenosis results from OPLL，which often combines with cervical OPLL and OLF，often shows multiple manifestations.Posterior laminectomy and anterolateral decompression are suitable for those conditions.13 refs，2 figs.

(Authors)