• Norihiro Nishida, Fei Jiang, Junji Ohgi, Yuki Fuchigami, Yuta Imai, Hidenori Suzuki, Yogesh Kumaran, Masahiro Funaba, Kazuhiro Fujimoto, Yusuke Ichihara, Issei Tanaka, Takashi Sakai, and Xian Chen.
• Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube City, Japan. Electronic address: nishida3@yamaguchi-u.ac.jp.
• World Neurosurg. 2024 Oct 12.

ObjectiveThoracic ossification of the posterior longitudinal ligament (T-OPLL) causes myelopathy. Although posterior decompression for T-OPLL has shown positive results, patients with kyphotic curvatures often endure poor outcomes. Posterior decompression with fusion (PDF) has demonstrated better results compared to posterior decompression alone. This study aims to evaluate the effects of the posterior procedures for T-OPLL.MethodsA 3-dimensional finite element model of the C2-T12 spine, created from medical images, was used to develop the following T3-T4 OPLL compression models: an intact model (no surgery), 25% canal occupancy ratio (COR) OPLL, a discontinuous 25% COR OPLL, a continuous 50% COR OPLL, and a discontinuous 50% COR OPLL. These models were analyzed to evaluate the effects of posterior decompression (laminectomy [LN]) with varied fixation lengths (LN T3-T4, PDF T3-T4, LN T2-T5, and PDF T2-T5) in neutral, flexion, and extension positions.ResultsIncreased discontinuity in OPLL led to increased stress on the spinal cord. Posterior decompression reduced spinal cord stress in the neutral posture. However, in flexion and extension, spinal cord stress increased for LN T3-T4, LN T2-T5, and PDF T3-T4 compared to the neutral posture. Notably, PDF T2-T5 prevented an increase in spinal cord stress during these motions.ConclusionsEffective management of intervertebral mobility and the appropriate length of decompression are crucial for addressing the thickness and mobility of T-OPLL.Copyright © 2024 Elsevier Inc. All rights reserved.

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