Postoperative paralysis following posterior decompression with instrumented fusion for thoracic myelopathy caused by ossification of the posterior longitudinal ligament

J Clin Neurosci. 2011 Feb;18(2):294-6. doi: 10.1016/j.jocn.2010.04.030. Epub 2010 Oct 27.

Abstract

A 60-year-old man presented with thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL). His spinal cord was severely impinged anteriorly by a beak-type OPLL and posteriorly by ossification of the ligamentum flavum at T4/5. He underwent surgical posterior decompression with instrumented fusion (PDF). Immediately after surgery, he developed a Brown-Séquard-type paralysis, which spontaneously resolved without requiring the addition of OPLL extirpation. This example highlights that the risk of postoperative neurological deterioration cannot be eliminated even when PDF is selected as the surgical procedure for thoracic OPLL, especially in instances in which the spinal cord is severely compressed.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Decompression, Surgical / adverse effects*
  • Decompression, Surgical / instrumentation
  • Decompression, Surgical / methods
  • Humans
  • Internal Fixators / adverse effects
  • Internal Fixators / standards
  • Ligamentum Flavum / surgery*
  • Male
  • Middle Aged
  • Ossification of Posterior Longitudinal Ligament / etiology
  • Ossification of Posterior Longitudinal Ligament / surgery*
  • Paraplegia / etiology*
  • Postoperative Complications / etiology*
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery*
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / instrumentation
  • Spinal Fusion / methods
  • Thoracic Vertebrae / surgery