{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T02:45:55Z","timestamp":1772505955083,"version":"3.50.1"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) remains one of the most difficult-to-treat disorders for spine surgeons. In Japan, approximately 75% of patients with this condition are treated using posterior decompression with instrumented spinal fusion (PDF). In contrast, anterior decompression is the most effective method for relieving spinal cord compression. The authors treated nonambulatory patients with thoracic OPLL by either PDF or by their technique using anterior decompression through a posterior approach. In this study the surgical results of these procedures are compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This was a retrospective case series. From 2008 to 2018, 9 patients with thoracic OPLL who could not walk preoperatively were treated surgically. Three patients were treated by PDF (the PDF group) and 6 patients were treated by anterior decompression through a posterior approach (the modified Ohtsuka group). The degree of surgical invasion and the neurological conditions of the patients were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The PDF group had a shorter operative duration (mean 477 \u00b1 122 vs 569 \u00b1 92 minutes) and less intraoperative blood loss (mean 613 \u00b1 380 vs 1180 \u00b1 614 ml), although the differences were not statistically significant. The preoperative Japanese Orthopaedic Association (JOA) score was almost identical between the two groups; however, the latest JOA score and the recovery rate were significantly better in the modified Ohtsuka group than in the PDF group (8.8 \u00b1 1.5 vs 5.0 \u00b1 1.7 and 71.3% \u00b1 23.7% vs 28.3% \u00b1 5.7%, respectively). The walking ability was evaluated using the modified Frankel scale. According to this scale, 3 patients showed three grade improvements, 2 patients showed two grade improvements, and 1 patient showed one grade improvement in the modified Ohtsuka group. Three patients in the modified Ohtsuka group could walk without any support at the final follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The present study clearly indicated that the surgical outcomes of the authors\u2019 modified Ohtsuka procedure were significantly better than those of PDF for patients who could not walk preoperatively.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2020.7.spine20411","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T07:23:27Z","timestamp":1607671407000},"page":"492-497","source":"Crossref","is-referenced-by-count":6,"title":["Surgical results of nonambulatory patients caused by ossification of the posterior longitudinal ligaments in the thoracic spine: retrospective comparative study between posterior decompression and instrumented spinal fusion versus anterior decompression through a posterior approach"],"prefix":"10.3171","volume":"34","author":[{"given":"Toshimi","family":"Aizawa","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University School of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshimitsu","family":"Eto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University School of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ko","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University School of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruo","family":"Kanno","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University School of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Itoi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University School of Medicine; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University School of Medicine, Sendai, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s00586-019-06047-5","article-title":"Indication for anterior spinal cord decompression via a posterolateral approach for the treatment of ossification of the posterior longitudinal ligament in the thoracic spine: a prospective cohort study","volume":"29","author":"Kato S","year":"2020","unstructured":"Kato S, Murakami H, Demura S,  Indication for anterior spinal cord decompression via a posterolateral approach for the treatment of ossification of the posterior longitudinal ligament in the thoracic spine: a prospective cohort study. 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