De novo Ossification of the Posterior Longitudinal Ligament related to Pseudarthrosis after Anterior Cervical Decompression and Fusion with floating of the Ossification Foci
Citation Information :
Furuya T, Ijima Y, Saito J, Kitamura M, Orita S, Ohtori S, Inage K, Funayama T, Miura K. De novo Ossification of the Posterior Longitudinal Ligament related to Pseudarthrosis after Anterior Cervical Decompression and Fusion with floating of the Ossification Foci. J Spinal Surg 2017; 4 (3):130-132.
The aim of this article is to report a case of ossification of the posterior longitudinal ligament (OPLL) in a patient who showed a de novo ossification focus compressing the spinal cord at the pseudarthrosis site several years after anterior decompression and fusion treatment for OPLL using the floating method.
Background
Segmental motion of the ossification foci has been reported to promote OPLL development. The OPLL can grow longitudinally and thicken after laminoplasty, which allows segmental motion of the OPLL.
Case report
A 66-year-old man, who has a history of OPLL anterior surgery with floating method 11 year prior, showed a gradual increase in gait disturbance. Imaging analyses revealed a de novo ossification focus at the C6 to 7 pseudarthrosis level compressing the spinal cord anteriorly.
Discussion
The present case showed that there is a possibility of de novo OPLL development after pseudarthrosis of anterior decompression and fusion surgery, even after complete floating of the ossification foci.
Conclusion
The OPLL can develop under certain conditions even after anterior decompression and fusion surgery using a floating method. Thus, rigorous observation is essential for pseudarthrosis even though the initial neurological recovery may be good.
Clinical significance
The present case showed a close relationship between OPLL genesis and segmental motion.
How to cite this article
Koda M, Furuya T, Ijima Y, Saito J, Kitamura M, Orita S, Ohtori S, Inage K, Abe T, Funayama T, Noguchi H, Miura K, Nagashima K, Kumagai H, Yamazaki M. De novo Ossification of the Posterior Longitudinal Ligament related to Pseudarthrosis after Anterior Cervical Decompression and Fusion with floating of the Ossification Foci. J Spinal Surg 2017;4(3):130-132.
Anterior corpectomy comparing to posterior decompression surgery for the treatment of multi-level ossification of posterior longitudinal ligament: a meta-analysis. Int J Surg 2017 Apr;40:91-96.
Anterior decompression for cervical myelopathy caused by ossification of the posterior longitudinal ligament—anterior floating method of OPLL. Nihon Seikeigeka Gakkai Zasshi 1996 May;70(5):296-310.
Genomic study of ossification of the posterior longitudinal ligament of the spine. Proc Jpn Acad Ser B Phys Biol Sci 2014 Dec;90(10):405-412.
Current topics in pharmacological research on bone metabolism: promyelotic leukemia zinc finger (PLZF) and tumor necrosis factor-alpha-stimulated gene 6 (TSG-6) identified by gene expression analysis play roles in the pathogenesis of ossification of the posterior longitudinal ligament. J Pharmacol Sci 2006 Mar;100(3):205-210.
Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history. Spine (Phila Pa 1976) 2012 Mar;37(5):E309-E314.
Radiographic predictors for the development of myelopathy in patients with ossification of the posterior longitudinal ligament: a multicenter cohort study. Spine (Phila Pa 1976) 2008 Nov;33(24):2648-2650.
How does the ossification area of the posterior longitudinal ligament thicken following cervical laminoplasty? Spine (Phila Pa 1976) 2007 Sep;32(19):E551-E556.
How does the ossification area of the posterior longitudinal ligament progress after cervical laminoplasty? Spine (Phila Pa 1976) 2006 Nov;31(24):2807-2812.
Addition of instrumented fusion after posterior decompression surgery suppresses thickening of ossification of the posterior longitudinal ligament of the cervical spine. J Clin Neurosci 2016 Dec;34:162-165.
Posterior instrumented fusion suppresses the progression of ossification of the posterior longitudinal ligament: a comparison of laminoplasty with and without instrumented fusion by three-dimensional analysis. Eur Spine J 2016 May;25(5):1634-1640.
Spontaneous reduction in ossification of the posterior longitudinal ligament of the thoracic spine after posterior spinal fusion without decompression: a case report. Spine (Phila Pa 1976) 2014 Mar;39(6):E417-E419.
Bone union and remodelling of the non-ossified segment in thoracic ossification of the posterior longitudinal ligament after posterior decompression and fusion surgery. Eur Spine J 2015 Nov;24(11):2555-2559.
