Adopted By The Intervertebral Spinal Decompression Therapy For The Serious Thoracic OPLL

Objective:To explore the use of posterior circumferential decompression for the serious thoracic ossification of posterior longitudinal ligament passing the intervertebral space after a safe and effective treatment.Methods:Since May 2010 to May 2014,15 cases associated with ossification of the posterior longitudinal ligament(OPLL),occupation rate of more than 50% of the thoracic spinal stenosis underwent posterior decompression toroidal,9 males and 6 females included,age42-69 years,mean 56.3 years.Preoperative symptoms were severe spinal cord compression.From the posterior midline approach surgery,the first two segments to be in the upper and lower decompression,pedicle screw channel presets,and then segmented using the removal of the posterior wall of the spinal canal "open method" to complete the rear of the vacuum.After the upper and lower facet joints,articular resection,pushed to the outside of the intercostal nerve,revealing a gap and extrapyramidal disc tissue excised disc and vertebral OPLL bone.Separation dural adhesions front,after removal of the posterior longitudinal ligament with a special tool to upper and lower edges,collapsed,after removing OPLL block,after the completion of one or both sides in front of the spinal cord decompression.Finalization of pedicle screw fixation and interbody.Postoperative follow-up(mean follow-up of 21.5 months) underwent CT and MRI scans,Frankel classification evaluation function recovery,JOA score assess neurological conditions,Otani scoring system for postoperative clinical efficacy evaluation and calculation excellent rate,to evaluate the therapeutic effect.Results:14 cases of postoperative recovery that is,one case of unilateral lower limb motor function had decreased muscle strength one,three cases of postoperative cerebrospinal fluid leakage.Postoperative follow-up without thoracic instability,no loosening fracture.After the separation surgery dural OPLL and adhesions resulting in leakage of cerebrospinal fluid three cases.The operative time 180min-300 min,an average of 240min; bleeding150ml-270 ml,the average blood loss 168 ml.Frankel grade significantly improved the mean preoperative JOA score 3.5,last follow-up JOA score increased to 9.0,compared with the preoperative significant improvement(P <0.05).According to Otani score,excellent in 9cases,good in 5 cases,1 case,the difference between 0 cases; good rate of 93.3%.Conclusion:Using the line passing intervertebral spinal decompression treatment after thoracic toroidal ossification of the posterior longitudinal ligament can be revealed in a smaller range,using self-developed special surgical tools safe completion of the front bone resection,spinal decompression full,effective and postoperative.