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Abstract
Ossification of the posterior longitudinal ligament (OPLL) is an uncommon disorder that may be associated with slowly progressing neurological symptoms. We encountered a case of acute cervical myelopathy due to a ruptured disc in an asymptomatic patient with OPLL, who was surgically managed by the anterior approach and fusion. We report the case with a review of the relevant literature.
REFERENCES
1). Matsunaga S, Kukita M, Hayashi K, Shinkura R, Koriyama C, Sakou T, Komiya S. Pathogenesis of myelopathy in patients with ossification of the posterior longitudinal ligament. J Neurosurg. 2002; 96:168–172.
2). Matsunaga S, Sakou T, Taketomi E, Yamaguchi M, Okano T. The natural course of myelopathy caused by ossification of the posterior longitudinal ligament in the cervical spine. Clin Orthop. 1994; 305:168–177.
3). Tsuyama N. Ossification of the posterior longitudinal ligament of the spine. Clin Orthop. 1984; 184:71–84.
4). Tsuyama N, Imai T, Hotta Y. Histopathological findings of the ossification of the posterior longitudinal ligament of the cervical spine and their significance. J Jpn Orthop Assoc. 1981; 55:387–397.
5). Hanakita J, Suwa H, Namura S, Mizuno M, Ootsuka T, Asahi M. The significance of the cervical soft disc herniation in the ossification of the posterior longitudinal ligament. Spine. 1994; 19:412–418.
6). Belanger TA, Roh JS, Hanks SE, Kand JD, Emery SE, Bolman HH. Ossification of the posterior longitudinal ligament. Results of anterior cervical decompression and arthrodesis in sixty-one north American patients. J Bone Joint Surg. 2005; 87A:610–615.
7). Harsh GR 4th, Sypert GW, Weinstein PR, Ross DA, Wilson CB. Cervical spine stenosis secondary to ossification of the posterior longitudinal ligament. J Neurosurg. 1987; 67:349–357.
8). Kojima T, Waga S, Kubo Y, Kanamaru K, Shimosaka S, Shimizu T. Anterior cervical vertebrectomy and interbody fusion for multilevel spondylosis and ossification of the posterior longitudinal ligament. Neurosurg. 1989; 24:864–872.
Fig. 1.
A sixty eight years old male visited our hospital with paresthesia of both hands and weakness of both upper and lower extrem-ities. Preoperative X-ray (A), 3-dimensional CT scan(B) and T2-weighted sagittal and axial MRI scan (C, D) reveal the severe cord compression due to ruptured disc of C4-5 and OPLL of C4-6. (A dotted line and a dotted arrow indicate the OPLL mass and a solid arrow indicates the ruptured disc at C4-5 level.)
Fig. 2.
The patient underwent anterior discectomy of C4-5 with removal of huge free ruptured fragments. And corpectomy of C5 with careful removal of OPLL and iliac grafting with anterior ORION plate was performed. Postoperative X-ray (A) and T2-weighted sagittal MRI scan (B) show the markedly decompressed spinal cord.
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