Clinical calcium
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We performed 3 types of surgical procedures for thoracic myelopathy due to OPLL : posterior decompression, OPLL-extirpation, and posterior decompression with instrumented fusion (PDF). A considerable degree of neurological recovery was obtained in all patients who underwent PDF, despite the anterior impingement of the spinal cord by OPLL remaining. In addition, the rate of post-operative complications was extremely low with PDF, when compared with posterior decompression and OPLL-extirpation groups. We recommend that one stage posterior decompression with instrumented fusion be selected for cases in whom the spinal cord is severely damaged pre-operatively.
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We retrospectively studied patients with cervical myelopathy due to OPLL to compare surgical outcome of anterior approach with that of laminoplasty. In patients with occupying ratio > or = 60%, the anterior approach yielded a better neurological outcome than laminoplasty. Although the anterior approach is technically demanding and has a higher incidence of surgery-related complications, it is preferable to laminoplasty for patients with occupying ratio of OPLL > or = 60%and/or hill-shaped ossification.