Trauma-induced myelopathy in patients with ossification of the posterior longitudinal ligament

Matsunaga, Shunji; Sakou, Takashi; Hayashi, Kyoji; Ishidou, Yasuhiro; Hirotsu, Masataka; Komiya, Setsuro

doi:10.3171/spi.2002.97.2.0172

Cited by 36 publications

(32 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Matsunaga et al [14] reported that myelopathy developed in all 45 patients with an occupation rate ≥60%. Therefore, in this study, to create an occupation rate ≥60%, analysis was performed by changing the size of OPLL so that the occupation rate became 70%, respectively.…”

Section: Production and Analysis Of Femsmentioning

confidence: 99%

A Biomechanical Study on Laminectomy and Dekyphosis for Thoracic Ossification of the Posterior Longitudinal Ligament

Okayama

Murakami

Demura

et al. 2013

Advances in Mechanical Engineering

View full text Add to dashboard Cite

We have successfully employed two-step circumspinal decompression for the treatment of thoracic OPLL. In the first step, laminectomy is performed according to the ossified lesion, and then correcting fixation of kyphosis (dekyphosis) is performed using instrumentation. In this study, we reconstructed the first step by a FEM. A commercially available FEM of the human body, THUMS, was used for the modeling of the operative procedure. The spinal cord and OPLL were incorporated into this model. After applying imposed displacement to OPLL, mechanical stress on the spinal cord was measured before or after posterior decompression at the occupying rates in the spinal canal between 0 and 70% in this model. When the occupancy rate was greater than 60%, the stress decreased after decompression compared to before decompression. The stress decreased by up to 52.3%. For reconstruction of dekyphosis, the change in the stress was analyzed after imposed displacement by which the spine was decreased: the cobb angle decreased by 10 degrees between T7 to T11. As a result, the stress further decreased by 14.6%. The present study proved the usefulness of posterior decompression and dekyphosis in order to reduce the pressure of the spinal cord in circumspinal decompression.

show abstract

Section: Production and Analysis Of Femsmentioning

confidence: 99%

A Biomechanical Study on Laminectomy and Dekyphosis for Thoracic Ossification of the Posterior Longitudinal Ligament

Okayama

Murakami

Demura

et al. 2013

Advances in Mechanical Engineering

View full text Add to dashboard Cite

show abstract

“…Severe myelopathy can be induced by minor trauma in patients with these diseases, [3][4][5][8][9][10][11]14) but the relative risk of spinal cord injury associated with such conditions is still unknown.…”

Section: Introductionmentioning

confidence: 99%

“…Providing information concerning the risk of trauma-induced myelopathy may be important for patients with OPLL without myelopathy at the initial consultation. 10) The frequency of cervical trauma decreased by 24% as a result of efforts by patients to avoid trauma. In the present study, 14 of 25 patients with degenerative cervical diseases were asymptomatic.…”

mentioning

confidence: 99%

Clinical Analysis of Spinal Cord Injury With or Without Cervical Ossification of the Posterior Longitudinal Ligament, Spondylosis, and Canal Stenosis in Elderly Head Injury Patients

Nakae

Onda

Yokobori

et al. 2010

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Patients with degenerative diseases of the cervical spine, such as ossification of the posterior longitudinal ligament, spondylosis, and canal stenosis, sometimes present with acute spinal cord injury caused by minor trauma. However, the relative risk of cervical cord injury with these diseases is unknown. The clinical and radiological features of 94 elderly patients with head injury, 57 men and 37 women aged from 65 to 98 years (mean 76.6 years), were retrospectively analyzed to assess the association of spinal cord injury with degenerative cervical diseases. Degenerative cervical diseases were present in 25 patients, and spinal cord injury was more common in the patients with degenerative diseases (11/25 patients) than in the patients without such diseases (3/69 patients; relative risk ＝ 10.2). The incidence of degenerative cervical diseases seems to be increasing in Japan because life expectancy has increased and the elderly are a rapidly growing part of the population. A fall while walking or cycling is a common mechanism of head injury and/or cervical cord injury in the elderly. To decrease the occurrence of cervical myelopathy, prevention by increasing social awareness and avoiding traffic accidents and falls is important.

show abstract

“…3,5,6 There is usually only chronic progression even in patients who present with neurological symptoms. 3,[5][6][7] Therefore, acute presentation in the absence of trauma is unusual in people with OPLL.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] For the patients without myelopathy, only 17-20% developed myelopathy in prospective studies. 3,5,6 There is usually only chronic progression even in patients who present with neurological symptoms. 3,[5][6][7] Therefore, acute presentation in the absence of trauma is unusual in people with OPLL.…”

Section: Introductionmentioning

confidence: 99%

Spinal cord infarction at the level of ossification of the posterior longitudinal ligament

Tanida

Kamimura

Tanishima

et al. 2016

Spinal Cord Ser Cases

View full text Add to dashboard Cite

INTRODUCTION:We report a case of acute tetraplegia, without any trauma or symptoms prior to onset, who presented with ossification of the posterior longitudinal ligament (OPLL) in the cervical spine with concomitant spinal cord infarction. CASE PRESENTATION: A 64-year-old man with a number of risk factors for vascular disease was admitted to our hospital with progressive motor weakness in the bilateral upper and lower extremities. He had initially felt numbness in his left upper extremity and had no previous neurological symptoms or trauma. The night after the initial symptoms, he developed spastic tetraplegia requiring respiratory support. Computed tomography images of the cervical spine demonstrated the segmental type of OPLL. Spinal cord compression and signal intensity changes were identified at the level of C3/4 on magnetic resonance imaging (MRI). He underwent emergency surgery consisting of posterior decompression with laminoplasty of C3-6. Despite the surgery, the patient's tetraplegia did not improve and he continued to require respirator support. There was still no improvement in his neurological status at 10 days postoperatively, and MRI demonstrated evidence of marked spinal cord infarction. DISCUSSION: Mechanical compression of spinal arteries by OPLL and pre-existing vascular compromise had a role in the pathogenesis of spinal cord infarction. Chronic spinal compression may be characterized by 3 important factors, namely an uncommonly devastating clinical course, vascular risk factors and persistent findings on MRI, and these might lead to early diagnosis of spinal cord infarction.

show abstract

Trauma-induced myelopathy in patients with ossification of the posterior longitudinal ligament

Cited by 36 publications

References 20 publications

A Biomechanical Study on Laminectomy and Dekyphosis for Thoracic Ossification of the Posterior Longitudinal Ligament

A Biomechanical Study on Laminectomy and Dekyphosis for Thoracic Ossification of the Posterior Longitudinal Ligament

Clinical Analysis of Spinal Cord Injury With or Without Cervical Ossification of the Posterior Longitudinal Ligament, Spondylosis, and Canal Stenosis in Elderly Head Injury Patients

Spinal cord infarction at the level of ossification of the posterior longitudinal ligament

Contact Info

Product

Resources

About