{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:06:21Z","timestamp":1776729981907,"version":"3.51.2"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81972103"],"award-info":[{"award-number":["81972103"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the postoperative progression of multilevel thoracic posterior longitudinal ligament (OPLL) at circumferential decompression (CD) levels and evaluate the long\u2010term results after CD <jats:italic>via<\/jats:italic> the posterior approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data from 16 patients with thoracic myelopathy secondary to OPLL who underwent CD at a single center were evaluated retrospectively from 2007 to 2014 and were followed up for more than 60\u00a0months. Patients of all sexes and ages were included in the study. Thin\u2010slice computed tomography scans obtained at the time of surgery and the most recent follow\u2010up were analyzed. The ossified area was measured on the axial reconstructed scan of the most obvious protrusion of ossification at the CD level. The neurological outcomes were evaluated using modified Japanese Orthopaedic Association (JOA) scores and Hirabayashi recovery rates (HRRs). Continuous variables were presented as the mean\u2009\u00b1\u2009standard deviation and were analyzed using the Student's <jats:italic>t<\/jats:italic>\u2010test, while categorical variables were tested using Fisher's exact test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among all patients, the most predominant type was the mixed type (9\/16, 56.3%), while the circumscribed type was only found in two patients (12.5%), and the continuous type was found in five patients (31.2%). Six cases were associated with ossification of the ligamentum flavum, and two cases were combined with cervical OPLL. The OPLL area at the CD level increased in all patients. The mean follow\u2010up period was 5.5\u2009\u00b1\u20090.92\u2009years (range 5\u20138\u2009years). The mean area of ossification increased from 35.63\u2009\u00b1\u200939.23\u2009mm<jats:sup>2<\/jats:sup> at the time of surgery to 99.94\u2009\u00b1\u200965.39\u2009mm<jats:sup>2<\/jats:sup> at the last follow\u2010up visit (<jats:italic>P<\/jats:italic> &lt;\u20090.01). There was no internal fixation disorder on any computed tomography scan after the operation. The average JOA score of all patients improved from 4.2\u2009\u00b1\u20092.2 points before surgery to 8.4\u2009\u00b1\u20092.6 points at the final follow\u2010up (<jats:italic>P<\/jats:italic> &lt;\u20090.01). The overall HRR was 61.8%. None of the patients exhibited any neurological deterioration due to OPLL progression. One patient developed a severe gait disturbance due to worsening lumbar canal stenosis, an unrelated cause, but the other 15 experienced gait disturbance improvements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>According to the long\u2010term follow\u2010up results, although OPLL progression did not decrease or stop after removing the OPLL mass, CD is a safe and effective procedure that can provide adequate reserve ventral space to cope with postoperative OPLL progression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13182","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T12:22:10Z","timestamp":1639657330000},"page":"298-305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010Term Follow\u2010Up of Multilevel Thoracic Ossification of the Posterior Longitudinal Ligament Following Circumferential Decompression <scp><i>via<\/i><\/scp> Posterior Approach: A Retrospective Study"],"prefix":"10.1111","volume":"14","author":[{"given":"Xiao","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu\u2010heng","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing\u2010peng","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8140-0361","authenticated-orcid":false,"given":"Feng","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chui\u2010guo","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010guang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9512-5436","authenticated-orcid":false,"given":"Wei\u2010shi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking University Third Hospital  Beijing China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine  Beijing China"},{"name":"Beijing Key Laboratory of Spinal Disease Research  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001643"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12165"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181714515"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-1266-4"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.12.FOCUS10282"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31816c913b"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12331"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-013-2489-0"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-4106-5"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.03.229"},{"key":"e_1_2_9_12_1","first-page":"3371","article-title":"Circumferential decompression via the posterior approach for the surgical treatment of multilevel thoracic ossification of the posterior longitudinal ligaments: a single institution comparative study","volume":"127","author":"Liu X","year":"2014","journal-title":"Chin Med J (Engl)"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06520-6"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31826efd89"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.7.SPINE131191"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.9.SPINE12548"},{"key":"e_1_2_9_17_1","first-page":"1","article-title":"Risk factors for progression of ossification of the posterior longitudinal ligament in asymptomatic subjects","author":"Doi T","year":"2020","journal-title":"J Neurosurg Spine"},{"key":"e_1_2_9_18_1","first-page":"221","article-title":"Circumferential spinal cord decompression through a posterior midline approach with lateral auxiliary ports for lower thoracic compressive myelopathy","volume":"70","author":"Lee SE","year":"2012","journal-title":"Neurosurgery"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.06.091"}],"container-title":["Orthopaedic 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