Long-term follow-up of the progression of ossification of the posterior longitudinal ligament

The authors report the case of a man with cervical ossification of the posterior longitudinal ligament (OPLL) who was observed for more than 26 years. Initial symptoms consisted of subtle numbness of the hands, and initial radiography showed small, segmental-type OPLL in the cervical spine. Lateral radiography of the cervical spine was performed every few years. Ossification accelerated for about 4 years during the follow-up. Segmental-type OPLL developed into mixed-type extensive OPLL. This case shows an accelerating maturation process of OPLL over the course of a few years. Segmental-type OPLL appears to represent an initial stage of extensive OPLL.

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Long-term Follow-up of Myelopathy due to Ossification of the Posterior Longitudinal Ligament（OPLL） and Spondylosis of the Cervical Spine

Spinal Surgery ◽

10.2531/spinalsurg.9.1 ◽

1995 ◽

Vol 9 (0) ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Chikao Nagashima ◽

Hidehiko Yoshizawa

Keyword(s):

Cervical Spine ◽

Posterior Longitudinal Ligament ◽

Long Term Follow Up

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Supratentorial Brain AVM Embolization with Onyx-18 and Post-Embolization Management

Interventional Neuroradiology ◽

10.1177/159101990901500304 ◽

2009 ◽

Vol 15 (3) ◽

pp. 275-282 ◽

Cited By ~ 9

Author(s):

J. W. Pan ◽

H.J. Zhou ◽

R.Y. Zhan ◽

S. Wan ◽

M. Yan ◽

...

Keyword(s):

Arteriovenous Malformations ◽

Subsequent Treatment ◽

Additional Surgery ◽

Brain Avm ◽

Initial Symptoms ◽

Complete Obliteration ◽

Long Term Follow Up ◽

Long Term Prognosis

Onyx is increasingly used in endovascular therapy of intracranial arteriovenous malformations (AVMs). However, the embolic effect and post-embolization management are still under discussion. We report our experience in the treatment of supratentorial brain arteriovenous malformations (SBAVMs) with Onyx and discuss post-embolic management. From June 2006 to July 2008, 20 patients with SBAVM were embolized with Onyx. There were 14 men and six women ranging from 14 to 64 years of age (mean 38.3 years). Initial symptoms included spontaneous hemorrhage (n=12), headaches (n=4), seizure (n=3) and incidentally disclosed after head trauma (n=1). After the endovascular procedure, all had subsequent treatment (follow-up angiogram, stereotactic radiosurgery or microsurgery) according to the obliteration degree. At angiography, seven patients (35%, 7/20) were completely obliterated (over 95% closure) after embolization while one suffered a small subarachnoid hemorrhage without permanent clinical sequelae. Four patients (20%, 4/20) were subtotally obliterated (over 80% closure), one patient who suffered severe cerebral edema after embolization underwent decompressive craniectomy, two patients had additional radiosurgery and one patient had follow-up angiogram. Nine patients (45%, 9/20) were partially obliterated (20–80% closure), five patients had additional surgery, two patients had additional radiosurgery and two patients had follow-up angiogram (one patient had intraventricular hemorrhage three months after embolization). Of all 20 AVMs, an average of 2.2 ml Onyx was used per patient and average volume reduction was 80% (range, 30%–99%). Onyx is suitable for embolization of SBAVMs because of its diffuse controllable properties. We suggest clinical follow-up after complete obliteration, additional radiosurgery or angiographic follow-up after subtotal obliteration and additional surgery after partially obliteration. More cases with long-term follow-up are needed to evaluate the long-term prognosis of our post-embolization management.

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Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.5.4.313 ◽

2006 ◽

Vol 5 (4) ◽

pp. 313-319 ◽

Cited By ~ 35

Author(s):

Hideki Sudo ◽

Manabu Ito ◽

Kuniyoshi Abumi ◽

Yoshihisa Kotani ◽

Tatsuto Takeuchi ◽

...

Keyword(s):

Cervical Spine ◽

Spinal Fusion ◽

Posterior Instrumentation ◽

Survival Rates ◽

Spinal Instability ◽

Initial Surgery ◽

Long Term Follow Up ◽

Spine Disorders

Object As increasing numbers of patients receive long-term hemodialysis, the number of reports regarding hemodialysis-related cervical spine disorders has also increased. However, there have been few reports summarizing the surgical results in patients with these disorders. The objective of this study was to evaluate the long-term follow up and clinical results after surgical treatment of cervical disorders in patients undergoing hemodialysis. Methods Seventeen patients in whom surgery was performed for cervical spine disorders while they received long-term hemodialysis therapy were enrolled in this study. Of these, 15 underwent follow-up review for more than 3 years after surgery, and these represent the study population. The remaining two patients died of postoperative sepsis. The average follow-up period was 120 months. Five patients without spinal instability underwent spinal cord decompression in which bilateral open-door laminoplasty was performed. Ten patients with destructive spondyloarthropathy (DSA) underwent reconstructive surgery involving pedicle screw (PS) fixation. In eight patients in whom posterior instrumentation was placed, anterior strut bone grafting was performed with autologous iliac bone to treat anterior-column destruction. Marked neurological recovery was obtained in all patients after the initial surgery. In the mobile segments adjacent to the site of previous spinal fusion, the authors observed progressive destructive changes with significant instability in four patients (40%) who underwent circumferential spinal fusion. No patients required a second surgery after laminoplasty for spinal canal stenosis without DSA changes. Conclusions Cervical PS-assisted reconstruction provided an excellent fusion rate and good spinal alignment. During the long-term follow-up period, however, some cases required extension of the spinal fusion due to the destructive changes in the adjacent vertebral levels. Guidelines or recommendations to overcome these problems should be produced to further increase the survival rates of patients undergoing hemodialysis.

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