Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2024
Three-dimensional morphological changes in ossification of the posterior longitudinal ligament of the thoracic spine following posterior decompression and fusion surgery.
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Shibuya Yohei, Katsumi Keiichi, Watanabe Kei, Ohashi Masayuki, Hirano Toru, Izumi Tomohiro, Kawashima Hiroyuki
Аннотация
BACKGROUND: Using three-dimensional image analysis, we previously reported suppression of ossification progression following posterior fusion surgery for cervical ossification of the posterior longitudinal ligament (OPLL). Here, we aimed to evaluate the morphological changes in thoracic OPLL using three-dimensional analysis.
METHODS: Seventeen patients (eight males and nine females; mean age, 56.9 years) who underwent posterior decompression and fusion (PDF) for thoracic OPLL were included. We evaluated the OPLL volume using a novel analysis involving creating a three-dimensional model from computed tomography images to measure the volume accurately. Additionally, OPLL thickness, width, and length were measured on sagittal and axial computed tomography planes. We investigated the morphological changes in OPLL after PDF. Furthermore, patients were classified into reduced volume and increased volume groups and associated factors were compared.
RESULTS: The mean OPLL volume was 1,677 mm3 preoperatively and 1,705 mm3 at the final examination and did not significantly differ. Volume reduction was observed in 7 of 17 cases (41 %). Although OPLL width and length significantly increased postoperatively, OPLL thickness significantly reduced from 7.1 mm preoperatively to 6.5 mm postoperatively (all, p < 0.05). The annual thickness changes significantly differed (p <0.05) in the reduced volume group (-0.36 mm/year) compared to that in the increased volume group (-0.06 mm/year).
CONCLUSIONS: Thoracic OPLL after PDF becomes thinner in the anteroposterior direction but increases horizontally and craniocaudally. The reduction in OPLL thickness was related to a reduction in ossification volume. We believe that volume reduction in thoracic OPLL is influenced by pulsation of the dural sac.
METHODS: Seventeen patients (eight males and nine females; mean age, 56.9 years) who underwent posterior decompression and fusion (PDF) for thoracic OPLL were included. We evaluated the OPLL volume using a novel analysis involving creating a three-dimensional model from computed tomography images to measure the volume accurately. Additionally, OPLL thickness, width, and length were measured on sagittal and axial computed tomography planes. We investigated the morphological changes in OPLL after PDF. Furthermore, patients were classified into reduced volume and increased volume groups and associated factors were compared.
RESULTS: The mean OPLL volume was 1,677 mm3 preoperatively and 1,705 mm3 at the final examination and did not significantly differ. Volume reduction was observed in 7 of 17 cases (41 %). Although OPLL width and length significantly increased postoperatively, OPLL thickness significantly reduced from 7.1 mm preoperatively to 6.5 mm postoperatively (all, p < 0.05). The annual thickness changes significantly differed (p <0.05) in the reduced volume group (-0.36 mm/year) compared to that in the increased volume group (-0.06 mm/year).
CONCLUSIONS: Thoracic OPLL after PDF becomes thinner in the anteroposterior direction but increases horizontally and craniocaudally. The reduction in OPLL thickness was related to a reduction in ossification volume. We believe that volume reduction in thoracic OPLL is influenced by pulsation of the dural sac.