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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 2/2008

01-02-2008 | Orthopaedic Surgery

Two-staged decompression for thoracic paraparesis due to the combined ossification of the posterior longitudinal ligament and the ligamentum flavum: a case report

Authors: Akira Hioki, Kei Miyamoto, Hideo Hosoe, Katsuji Shimizu

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2008

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Abstract

Study design

A case report of ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the ligamentum flavum, or yellow ligament (OYL), in the upper thoracic spine.

Objective

To describe a rare clinical entity and its management pitfalls in a patient with upper thoracic myelopathy due to combined OPLL and OYL.

Methods

A 52-year-old woman developed paresthesia and paraparesis of both legs. One month prior to admission she fell and became unable to walk. She was diagnosed as having upper thoracic myelopathy due to combined OPLL and OYL and was treated by two-stage anterior and posterior spinal decompression. Posterior decompression was achieved first by laminoplasty at C3–Th1 and laminectomy of Th2 and Th3.

Results

After posterior decompression, her symptoms immediately and dramatically improved. However, symptoms recurred after she was able to achieve a sitting or standing position. We then performed anterior decompression at Th2, which again improved her symptoms. At two years post-surgery, she is ambulatory with the use of a cane.

Conclusion

Upper thoracic myelopathy due to OPLL and OYL was treated by combined 2-staged anterior and posterior decompression. In this case, posterior decompression alone was inadequate to relieve the symptoms of this pathological condition.
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Metadata
Title
Two-staged decompression for thoracic paraparesis due to the combined ossification of the posterior longitudinal ligament and the ligamentum flavum: a case report
Authors
Akira Hioki
Kei Miyamoto
Hideo Hosoe
Katsuji Shimizu
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 2/2008
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-007-0336-5

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