Volume 8, Number 4, December 2018
|Number of page(s)||4|
|Published online||26 November 2018|
A rare case of extensive cervico-thoracic ossification of the posterior longitudinal ligament causing myelopathy
Department of Orthopaedic Surgery, Spine Division, Tan Tock Seng Hospital, Singapore
2 Department of Orthopaedic Surgery, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Tamil Nadu, India
* Corresponding author. Department of Orthopaedic Surgery, Spine Division, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. E-mail address: Jacob_YL_OH@ttsh.com.sg (J. Y. L. Oh).
Accepted: 25 July 2018
Ossification of the posterior longitudinal ligament (OPLL) most commonly occurs in the cervical spine, usually involving two to three segments; however, the disease has the potential to occur anywhere in the spine. We encountered a fifty-one year old male with progressive unsteadiness and bilateral lower limb weakness for a period of six months which eventually became worse resulting in inability to walk without assistance. Neurological examination revealed normal upper limb function; however, the lower limbs demonstrated motor dysfunction. Signs of myelopathy were elicited and the patient was subjected to detailed radiological evaluation. CT and MRI scans revealed an extensive cervico-thoracic continuous OPLL from C3 to T3 causing significant cord compression. In view of the deteriorating neurological status, extensive C3-T3 laminectomy with instrumented posterolateral fusion was done and the patient recovered without any immediate or delayed C5 palsy. This case highlights a rare occurrence or extensive OPLL involving eight segments at the cervico-thoracic region. This report also discusses surgical strategies for managing such extensive presentations and our technique to prevent C5 palsy.
Key words: Cervical spondylosis / Myelopathy / Neurodegenerative diseases / Ossification of posterior longitudinal ligament / Spine
© Author(s) 2018. This article is published with open access by China Medical University
Open Access This article is distributed under terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided original author(s) and source are credited.
Current usage metrics show cumulative count of Article Views (full-text article views including HTML views, PDF and ePub downloads, according to the available data) and Abstracts Views on Vision4Press platform.
Data correspond to usage on the plateform after 2015. The current usage metrics is available 48-96 hours after online publication and is updated daily on week days.
Initial download of the metrics may take a while.