1999 Fiscal Year Final Research Report Summary
Investigation on anatomical factors inhibiting the posterior shift of the thoracic spinal cord and the development of reliable methods of posterior decompression of the spinal cord for the thoracic OPLL-myelopathy
| Project/Area Number |
10671378
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Saitama Medical School |
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Principal Investigator |
TSUZUKI Nobuyuki Saitama Medical School, Medical Department, Professor, 医学部, 教授 (10049794)
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| Co-Investigator(Kenkyū-buntansha) |
SAIKI Kunio Saitama Medical School, Medical Department, Lecturer, 医学部, 講師 (40215520)
ABE Ryoji Kasnetsu Hospital, Department of Orthopaedic Surgery, Head of Department, 整形外科, 部長 (30193014)
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| Project Period (FY) |
1998 – 1999
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| Keywords | thoracic spine / ossification of the posterior longitudinal ligament / thoracic myelopathy / posterior approach |
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| Research Abstract |
As a method of safe and reliable decompression of the spinal cord for thoracic-OPLL myelopathy, the posterior approach was selected and its disadvantage, I.e., the insufficient degree of decompression caused by thoracic kyphosis, was improved by elimination of three major anatomical factors which inhibited the posterior shift of the thoracic spinal cord. They were: (1) longitudinal factor, I.e., anterior pulling effects of spinal cord segments, above and below OPLL, (2) longitudotransverse factor, I.e., holding-down effect of the parts of dura; mid-dorsal part and lateral part which extended into nerve-sheath, (3) transverse factor, I.e., anterior tethering effect of thoracic roots and denticular ligaments. Means of elimination of these factors were: (1) extensive cervicothoracic laminoplastic decompression, (2) longitudinal durotomy, (3) facetectomy and root-OPLL release. OPLL resection or anterior transfer was finally performed if necessary. These procedures were performed through staged posterior approaches in fifteen cases of thoracic OPLL-myelopathy. A mean age was 56 years (range: 42-68 years) and a mean follow-up was 42 months (range: 5-100 months). Neurology improved in all cases, with little postoperative complications. Radiological pictures proved the effectiveness of elimination of posterior-shift-inhibiting factors for the spinal cord decompression.
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