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European Spine Journal

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01-08-2018 | Ideas and Technical Innovations

The bridge crane technique for the treatment of the severe thoracic ossification of the ligamentum flavum with myelopathy

Authors: Jingchuan Sun, Kaiqiang Sun, Jiangang Shi, Ximing Xu, Yuan Wang, Qingjie Kong

Published in: European Spine Journal | Issue 8/2018

Abstract

Purpose

This study aims to investigate the clinical effect and complications of a novel technique named bridge crane for the treatment of the severe thoracic ossification of the ligamentum flavum (TOLF) with myelopathy.

Method

A patient diagnosed as TOLF (T9–T11) was treated with the bridge crane technique and the outcomes were reported. The main surgical procedures include installation of pedicle screws, rods and transverse connectors; preparation of stay prolene sutures passing through the laminae-OLF complex (LOC); en bloc isolation of the LOC; tightening of the sutures to achieve posterior suspension of the LOC; and fixation of the LOC to the transverse connectors. The modified Japanese Orthopaedic Association (mJOA) scale was studied. The pre- and postoperative radiological parameters and surgical complications were also investigated.

Results

Postoperative CT and MRI showed a sufficient decompression of spinal cord by the technique of bridge crane. The ratio of spinal canal encroachment improved significantly. At the final follow-up assessment, no specific complications were identified. Imaging information suggested that the bone graft was fused and the “bridge” was in good position. The mJOA score was 9 with a recovery rate of 75% at the final follow-up.

Conclusions

The technique of bridge crane is feasible and may be relatively safe and effective for the treatment of severe TOLF with myelopathy. However, further studies with large-scale cases and control groups are required to reveal the generalizability and safety of the bridge crane technique in the future.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: The bridge crane technique for the treatment of the severe thoracic ossification of the ligamentum flavum with myelopathy
Authors: Jingchuan Sun
Kaiqiang Sun
Jiangang Shi
Ximing Xu
Yuan Wang
Qingjie Kong
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5683-0

At a glance: The STEP trials

Springer Medicine

The bridge crane technique for the treatment of the severe thoracic ossification of the ligamentum flavum with myelopathy

Abstract

Purpose

Method

Results

Conclusions

Graphical abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Method

Results

Conclusions

Graphical abstract

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