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Resection of Beak-Type Thoracic Ossification of the Posterior Longitudinal Ligament from a Posterior Approach under Intraoperative Neurophysiological Monitoring for Paralysis after Posterior Decompression and Fusion Surgery
http://hdl.handle.net/2237/25415
4abce308-c170-449b-aae1-436fe3df759f
名前 / ファイル | ライセンス | アクション | |
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2017-01-18 | |||||
タイトル | ||||||
タイトル | Resection of Beak-Type Thoracic Ossification of the Posterior Longitudinal Ligament from a Posterior Approach under Intraoperative Neurophysiological Monitoring for Paralysis after Posterior Decompression and Fusion Surgery | |||||
著者 |
Imagama, Shiro
× Imagama, Shiro× Ando, Kei× Ito, Zenya× Kobayashi, Kazuyoshi× Hida, Tetsuro× Ito, Kenyu× Ishikawa, Yoshimoto× Tsushima, Mikito× Matsumoto, Akiyuki× Tanaka, Satoshi× Morozumi, Masayoshi× Machino, Masaaki× Ota, Kyotaro× Nakashima, Hiroaki× Wakao, Norimitsu× Nishida, Yoshihiro× Matsuyama, Yukihiro× Ishiguro, Naoki |
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権利 | ||||||
権利情報 | CC BY-NC-ND | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | T-OPLL | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | RASPA | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | salvage surgery for paralysis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | additional dekyphosis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | spinal cord shortening | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | intraoperative neurophysiological monitoring | |||||
抄録 | ||||||
内容記述 | Study Design: Prospective clinical study. Objective: Posterior decompression and fusion surgery for beak-type thoracic ossification of the posterior longitudinal ligament (T-OPLL) generally has a favorable outcome. However, some patients require additional surgery for postoperative severe paralysis, a condition that is inadequately discussed in the literature. The objective of this study was to describe the efficacy of a procedure we refer to as “resection at an anterior site of the spinal cord from a posterior approach” (RASPA) for severely paralyzed patients after posterior decompression and fusion surgery for beak-type T-OPLL. Methods: Among 58 consecutive patients who underwent posterior decompression and fusion surgery for beak-type T-OPLL since 1999, 3 with postoperative paralysis (5%) underwent RASPA in our institute. Clinical records, the Japanese Orthopaedic Association score, gait status, intraoperative neurophysiological monitoring (IONM) findings, and complications were evaluated in these cases. Results: All three patients experienced a postoperative decline in Manual Muscle Test (MMT) scores of 0 to 2 after the first surgery. RASPA was performed 3 weeks after the first surgery. All patients showed gradual improvements in MMT scores for the lower extremity and in ambulatory status; all could walk with a cane at an average of 4 months following RASPA surgery. There were no postoperative complications. Conclusions: RASPA surgery for beak-type T-OPLL after posterior decompression and fusion surgery resulted in good functional outcomes as a salvage surgery for patients with severe paralysis. Advantages of RASPA include a wide working space, no spinal cord retraction, and additional decompression at levels without T-OPLL resection and spinal cord shortening after additional dekyphosis and compression maneuvers. When used with IONM, this procedure may help avoid permanent postoperative paralysis. | |||||
内容記述タイプ | Abstract | |||||
出版者 | ||||||
出版者 | Georg Thieme Verlag | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源タイプresource | http://purl.org/coar/resource_type/c_6501 | |||||
タイプ | journal article | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 2192-5682 | |||||
書誌情報 |
Global Spine Journal 巻 6, 号 8, p. 812-821, 発行日 2016-12 |
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著者版フラグ | ||||||
値 | publisher | |||||
URI | ||||||
識別子 | https://doi.org/10.1055/s-0036-1579662 | |||||
識別子タイプ | DOI | |||||
URI | ||||||
識別子 | http://hdl.handle.net/2237/25415 | |||||
識別子タイプ | HDL |