PAN Weicheng,MENG Yake,SUN Jingchuan.Clinical observation of posterior controllable antedisplacement, fixation and decompression of thoracic vertebrae-ossification of posterior longitudinal ligament complex in the treatment of multilevel continuous ossification of posterior longitudinal ligament of thoracic vertebrae[J].Chinese Journal of Spine and Spinal Cord,2022,(5):395-401.
Clinical observation of posterior controllable antedisplacement, fixation and decompression of thoracic vertebrae-ossification of posterior longitudinal ligament complex in the treatment of multilevel continuous ossification of posterior longitudinal ligament of thoracic vertebrae
Received:January 16, 2022  Revised:March 17, 2022
English Keywords:Thoracic vertebra  Ossification of the posterior longitudinal ligament  Vertebrae-OPLL complex  Antedisplacement  Curative effect
Fund:国家自然科学基金项目(基金号:81972092)
Author NameAffiliation
PAN Weicheng Department of Spine Surgery, Changzheng Hospital, Naval Military Medical University, Shanghai, 200003, China 
MENG Yake 同济大学附属上海东方医院骨科 200003 上海市 
SUN Jingchuan 海军军医大学附属上海长征医院脊柱外科 200003 上海市 
张卫航  
梅子健  
蒋佳霖  
郑 冰  
郭永飞  
史建刚  
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English Abstract:
  【Abstract】 Objectives: To investigate the clinical efficacy of posterior antedisplacement, fixation and decompression technique in the treatment of multi-segment continuous thoracic ossification of posterior longitudinal ligament(T-OPLL). Methods: From May 2018 to June 2020, 22 patients with multi-segment continuous T-OPLL who received this technique in the Spinal Surgery Department of Shanghai Changzheng Hospital were retrospectively analyzed. Preoperative and postoperative visual analogue scale(VAS) of pain, Japanese Orthopaedic Association (JOA) score, Frankel grading, CT and MRI were recorded to evaluate the surgical effect. At the same time, the general conditions of the operation was recorded, and the diseased segments, clinical manifestations, postoperative complications were counted. Results: The follow-up period was 13-17(14.95±1.33) months. The operative time was 200-310min(238.19±34.73min), and the blood loss was 900-1800ml(1345.45±230.38ml). VAS scores were 7.59±0.73 points, 3.50±0.51 points, 2.41±0.50 points, and 1.55±0.51 points before surgery, 3 months after surgery, 12 months after surgery, and at final follow-up, respectively. There were significant differences in VAS scores between preoperative and postoperative 3 months, 12 months and final follow-up(P<0.05). The JOA scores were 4.64±1.84 points, 5.73±1.78 points, 6.82±1.33 points, and 9.23±0.81 points before surgery, 3 months after surgery, 12 months after surgery, and at final follow-up, respectively. There were statistically significant differences between preoperative and postoperative JOA scores at 3 months, 12 months and at final follow-up(P<0.05), and the average improvement rate of JOA score at the final follow-up was (73.64±12.57)%. The Frankel classification of all patients showed 1-3 grade improvement(14 cases of grade B, 4 cases of grade C, and 4 cases of grade D preoperatively recovered to grade E), and there were no complications such as loosening of internal fixation, broken screw and broken rod during postoperative follow-up visit. Conclusions: Posterior controllable antedisplacement, fixation and decompression of thoracic vertebrae-ossification of posterior longitudinal ligament complex can controllably move the vertebral ossification complex to the ventral side with the help of screw and rod fixation system, and achieve in situ decompression of the spinal cord without the removal of the ossification. It is a safe and effective new surgical method which provides a new idea for the treatment of posterior longitudinal ligament ossification of the thoracic spine.
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