• Jingchuan Sun, Kaiqiang Sun, Jiangang Shi, Ximing Xu, Yuan Wang, and Qingjie Kong.
• Second Department of Spine Surgery, Changzheng Hospital, 601 Room, 415# Fengyang Road, Huangpu District, Shanghai, China.
• Eur Spine J. 2018 Aug 1; 27 (8): 1846-1855.

PurposeThis study aims to investigate the clinical effect and complications of a novel technique named bridge crane for the treatment of the severe thoracic ossification of the ligamentum flavum (TOLF) with myelopathy.MethodA patient diagnosed as TOLF (T9-T11) was treated with the bridge crane technique and the outcomes were reported. The main surgical procedures include installation of pedicle screws, rods and transverse connectors; preparation of stay prolene sutures passing through the laminae-OLF complex (LOC); en bloc isolation of the LOC; tightening of the sutures to achieve posterior suspension of the LOC; and fixation of the LOC to the transverse connectors. The modified Japanese Orthopaedic Association (mJOA) scale was studied. The pre- and postoperative radiological parameters and surgical complications were also investigated.ResultsPostoperative CT and MRI showed a sufficient decompression of spinal cord by the technique of bridge crane. The ratio of spinal canal encroachment improved significantly. At the final follow-up assessment, no specific complications were identified. Imaging information suggested that the bone graft was fused and the "bridge" was in good position. The mJOA score was 9 with a recovery rate of 75% at the final follow-up.ConclusionsThe technique of bridge crane is feasible and may be relatively safe and effective for the treatment of severe TOLF with myelopathy. However, further studies with large-scale cases and control groups are required to reveal the generalizability and safety of the bridge crane technique in the future. These slides can be retrieved under Electronic Supplementary Material.

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