Transient paraparesis after laminectomy for thoracic ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum
Transient paraparesis after laminectomy for thoracic ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum
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DOI：
10.1038/sj.sc.3101807
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发表时间：
2006-02-01
期刊：
影响因子：
2.2
通讯作者：
Aiba, A
中科院分区：
文献类型：
--
作者：
Yamazaki, M;Koda, M;Aiba, A
研究设计：病例报告。目的：目的：报告1例后纵韧带骨化和韧带骨化引起的胸椎脊髓病。背景：日本一所大学医院。病例报告：一名71岁女性，双下肢痉挛性麻痹，在T10-T11发生OPLL和OLF，其前后挤压脊髓。她在T10-T11接受了椎板切除术，术后即刻未观察到进一步的神经功能恶化。然而，在接下来的18小时内，脊髓病恶化，表现出严重的下肢轻瘫。在T7-L1进行了额外的后路内固定融合，未矫正脊柱后凸。融合后，神经功能缺损逐渐恢复，尽管存在残留的前撞击脊髓的OPLL.Conclusions：目前的情况下提供的证据，椎板切除术单独产生术后瘫痪的可能性，合并胸OPLL和OLF，我们建议，后路器械融合应增加后路减压时，进行这种疾病。
Study design: Case report.Objectives: To report a case with thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum. avum (OLF), in which postoperative paralysis occurred after laminectomy and was reversed after an additional posterior instrumented fusion.Setting: A University Hospital in Japan.Case report: A 71-year-old woman, with a spastic palsy of both lower extremities, had OPLL and OLF at T10-T11, which pinched the spinal cord anteriorly and posteriorly. She underwent a laminectomy at T10-T11, and no further neurological deterioration was seen immediately after surgery. Over the next 18 h, however, myelopathy worsened, showing severe paraparesis. An additional posterior instrumented fusion at T7-L1 was performed without correction of the kyphosis. After fusion, neurological deficits gradually recovered, despite the presence of residual anterior impingement of spinal cord by the OPLL.Conclusions: The present case provides evidence for the possibility that laminectomy alone produces postoperative paralysis for combined thoracic OPLL and OLF, and we recommend that a posterior instrumented fusion should be added when posterior decompression is performed for this disorder.