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European Spine Journal

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01-12-2012 | Original Article

Thoracic myelopathy caused by ossification of the yellow ligament in patients with posterior instrumented lumbar fusion

Authors: Kee-Yong Ha, Jun-Yeong Seo, Il-Nam Son, Young-Hoon Kim, Ki-Won Kim

Published in: European Spine Journal | Issue 12/2012

Abstract

Purpose

The objective of this study was to investigate thoracic myelopathy caused by ossification of the yellow ligament (OYL) in patients with posterior instrumented lumbar fusion.

Methods

Seven patients, who had undergone posterior instrumented lumbar fusion, presented with thoracic myelopathy caused by OYL. No patient had a history of thoracic myelopathy at previous surgery. Instrumented fusions were performed from L1–5 in two patients, L2–5 in three patients and L1–S1 and L2–S1 in one patient each, respectively. MRI and CT scans were performed to confirm cord compression by OYL. Of the seven patients, six patients underwent decompressive laminectomy and OYL removal while one was treated conservatively.

Results

The average time to presentation after first surgery was 63.4 months. OYL was located at T9–10 in two patients, T11–12 in three patients, and T10–11 and T9–11 in one patient each, respectively. All patients had a myelopathic gait and the average Japanese Orthopaedic Association (JOA) score was 3.9, preoperatively. The average JOA score improved from 3.7 to 8 and the average recovery rate was 58.9 % in the six patients who underwent surgical intervention. However, the JOA score fell from 5 to 4 in the one patient who was treated conservatively.

Conclusions

We report seven patients who suffered from thoracic myelopathy after instrumented lumbar fusion. Surgeons must be aware of the possibility of thoracic myelopathy caused by OYL at the thoracolumbar junction, especially in patients with a complaint of gait disturbance after long instrumented lumbar fusion.

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Title: Thoracic myelopathy caused by ossification of the yellow ligament in patients with posterior instrumented lumbar fusion
Authors: Kee-Yong Ha
Jun-Yeong Seo
Il-Nam Son
Young-Hoon Kim
Ki-Won Kim
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 12/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2413-x

At a glance: The STEP trials

Springer Medicine

Thoracic myelopathy caused by ossification of the yellow ligament in patients with posterior instrumented lumbar fusion

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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