Cervical myelopathy due to ossification of the posterior longitudinal longitudinal ligament

1972 ◽  
Vol 37 (6) ◽  
pp. 653-660 ◽  
Author(s):  
Chikao Nagashima
Keyword(s):  
Cervical Myelopathy ◽  
Posterior Margin ◽  
Posterior Longitudinal Ligament ◽  
Foramen Magnum ◽  
Primary Lesion ◽  
Foramen Magnum Decompression ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Longitudinal Strip ◽  
Fine Print

✓ Ten patients who had cervical myelopathy due to ossification of the posterior longitudinal ligament of the cervical spine are described. This disease is characterized by an abnormal longitudinal strip of ossified ligamentous tissue along the posterior margin of vertebrae from C-3 to C-6; the primary lesion appears to be a degeneration of the intervertebral disc. This distinct clinical, radiological, and pathological entity should be included in the differential diagnosis of cervical myelopathy. All 10 patients were treated by extensive decompressive laminectomy and multiple bilateral facetectomies, with or without foramen magnum decompression. The results were favorable, and postoperative myelography demonstrated dorsal migration of the entire dural contents.

Radiculopathy of C-5 after anterior decompression for cervical myelopathy

2005 ◽  
Vol 3 (3) ◽  
pp. 210-217 ◽  
Author(s):  
Minoru Ikenaga ◽  
Jitsuhiko Shikata ◽  
Chiaki Tanaka
Keyword(s):  
Cervical Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Manual Muscle Testing ◽  
Radiographic Evaluation ◽  
Anterior Decompression ◽  
Content Type ◽  
Muscle Testing ◽  
Anterior Corpectomy ◽  
Fine Print

Object. The authors conducted a study to examine the incidence and causes of postoperative C-5 radiculopathy, and they suggest preventive methods for C-5 palsy after anterior corpectomy and fusion. Methods. The authors included in the study 18 patients with postoperative C-5 radiculopathy from 563 patients who underwent anterior decompression and fusion for cervical myelopathy. There were 10 cases of ossification of the posterior longitudinal ligament (OPLL) and eight cases of cervical spondylotic myelopathy (CSM). All patients received conservative treatment. Posttreatment full recovery was present in eight patients, and Grade 3/5 strength was documented in six in whom some weakness remained. Radiographic evaluation revealed that the C3–4 and C4–5 cord compression was significantly more severe in patients with paralysis than in those without paralysis. The incidence of paralysis was higher in patients with OPLL than in those with CSM (chi-square test, p = 0.03). The incidence of paralysis increased in parallel with the number of fusion levels (correlation coefficient r = 0.94). Multivariate analysis revealed that the final manual muscle testing (MMT) value was closely related to the preoperative MMT value (computed t value 4.17; p < 0.01) and preoperative Japanese Orthopaedic Association (JOA) score for cervical myelopathty (computed t value, 2.75; p < 0.05). Conclusions. Preexisting severe stenosis at C3–4 or C4–5 in patients with OPLL is a risk factor for paralysis. Preoperative muscle weakness and a low JOA score are factors predictive of poor recovery.

Stenosis of the axis and cervical myelopathy

1992 ◽  
Vol 76 (2) ◽  
pp. 296-297 ◽  
Author(s):  
Shankar G. Prakash ◽  
Mathew J. Chandy ◽  
Jacob Abraham
Keyword(s):  
Cervical Myelopathy ◽  
Rare Case ◽  
Neural Arch ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Remarkable Recovery ◽  
Fine Print

✓ A rare case is described of marked segmental stenosis of the axis secondary to developmental hypertrophy of the posterior neural arch causing cervical myelopathy. The patient made a remarkable recovery following decompressive laminectomy.

Ossification of the posterior atlantoaxial membrane

2003 ◽  
Vol 98 (1) ◽  
pp. 77-79 ◽  
Author(s):  
Katsumi Harimaya ◽  
Keiichiro Shiba ◽  
Hiroshi Nomura ◽  
Toru Iwaki ◽  
Yoshiharu Takemitsu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Cervical Myelopathy ◽  
Resonance Imaging ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Fine Print

✓ The authors report a case of ossification of the posterior atlantoaxial membrane that led to the development of cervical myelopathy. Computerized tomography and magnetic resonance imaging were helpful in establishing the diagnosis, and decompressive laminectomy may be an appropriate intervention.

Long-term results of expansive open-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine

2004 ◽  
Vol 1 (2) ◽  
pp. 168-174 ◽  
Author(s):  
Yuto Ogawa ◽  
Yoshiaki Toyama ◽  
Kazuhiro Chiba ◽  
Morio Matsumoto ◽  
Masaya Nakamura ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Myelopathy ◽  
Posterior Longitudinal Ligament ◽  
Clinical Results ◽  
Long Term Results ◽  
Open Door ◽  
Content Type ◽  
Anterior Posterior ◽  
Fine Print

Object. Numerous surgical procedures have been developed for treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, and these can be performed via three approaches: anterior, posterior, or combined anterior—posterior. The optimal approach in cases involving OPLL-induced cervical myelopathy, however, remains controversial. To address this issue, the authors assessed the benefits and limitations of expansive open-door laminoplasty for OPLL-related myelopathy by evaluating mid- and long-term clinical results. Methods. Clinical results obtained in 72 patients who underwent expansive open-door laminoplasty between 1983 and 1997 and who were followed for at least 5 years were assessed using the Japanese Orthopaedic Association (JOA) scoring system. The mean preoperative JOA score was 9.2 ± 0.4; at 3 years postoperatively, the JOA score was 14.2 ± 0.3 and the recovery rate (calculated using the Hirabayashi method) was 63.1 ± 4.5%, both having reached their highest level. These favorable results were maintained up to 5 years after surgery. An increase in cervical myelopathy due to progression of the ossified ligament was observed in only two of 30 patients who could be followed for more than 10 years. Severe surgery-related complications were not observed. Preoperative JOA score, age at the time of surgery, and duration between onset of initial symptoms and surgery affected clinical results. Conclusions. Mid-term and long-term results of expansive open-door laminoplasty were satisfactory. Considering factors that affected surgical results, early surgery is recommended for OPLL of the cervical spine.

Atlas hypoplasia as a cause of high cervical myelopathy

1993 ◽  
Vol 79 (6) ◽  
pp. 917-919 ◽  
Author(s):  
Yoji Komatsu ◽  
Tomoyuki Shibata ◽  
Susumu Yasuda ◽  
Yukio Ono ◽  
Tadao Nose
Keyword(s):  
Spinal Cord ◽  
Cervical Myelopathy ◽  
Neurological Recovery ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
High Cervical ◽  
Fine Print

✓ A high cervical myelopathy due to atlas hypoplasia is described in a 56-year-old man; the condition caused marked segmental compression of the spinal cord. A remarkable neurological recovery followed decompressive laminectomy of the atlas and adjacent regions. The authors discuss the embryology and etiology of this anomaly.

Foramen magnum syndrome from pseudogout of the atlanto-occipital ligament

1989 ◽  
Vol 71 (1) ◽  
pp. 141-143 ◽  
Author(s):  
Samuel F. Ciricillo ◽  
Philip R. Weinstein
Keyword(s):  
Posterior Longitudinal Ligament ◽  
Calcium Pyrophosphate ◽  
Foramen Magnum ◽  
Calcium Pyrophosphate Dihydrate ◽  
Transverse Ligament ◽  
Content Type ◽  
Pyrophosphate Dihydrate ◽  
Transoral Decompression ◽  
Calcium Pyrophosphate Dihydrate Crystals ◽  
Fine Print

✓ The authors report a case of progressive foramen magnum syndrome due to deposits of calcium pyrophosphate dihydrate crystals, which caused reactive hypertrophy in the posterior longitudinal ligament at C-1 and in the transverse ligament of the atlas in an 84-year-old woman. This is the first reported case of symptomatic pseudogout in this anatomic location. Rapid neurological recovery followed transoral decompression of the cervicomedullary junction.

Foramen magnum decompression in an infant with homozygous achondroplasia

1989 ◽  
Vol 70 (1) ◽  
pp. 126-128 ◽  
Author(s):  
Nathan Moskowitz ◽  
Benjamin Carson ◽  
Steven Kopits ◽  
Roy Levitt ◽  
Graeme Hart
Keyword(s):  
Upper Airway ◽  
Early Death ◽  
Foramen Magnum ◽  
Foramen Magnum Decompression ◽  
Thoracic Cage ◽  
Respiratory Compromise ◽  
Content Type ◽  
Surgical Measures ◽  
Cervicomedullary Compression ◽  
Fine Print

✓ Homozygous achondroplasia is a rare yet distinct clinical entity. Most infants succumb to an early death as a result of respiratory compromise due to upper airway obstruction, thoracic cage deformity, and/or cervicomedullary compression. The successful cervicomedullary decompression of a 16-week-old infant with homozygous achondroplasia is described. This report suggests that homozygous achondroplasia is not universally fatal and that these infants are potentially viable if managed by aggressive respiratory and surgical measures.

Syringomyelia without hindbrain herniation: tight cisterna magna

2002 ◽  
Vol 96 (2) ◽  
pp. 239-249 ◽  
Author(s):  
Kazuhiko Kyoshima ◽  
Takayuki Kuroyanagi ◽  
Fusakazu Oya ◽  
Yukihiro Kamijo ◽  
Hossam El-Noamany ◽  
...  
Keyword(s):  
Foramen Magnum ◽  
Central Canal ◽  
Foramen Magnum Decompression ◽  
Ventricular Dilation ◽  
Content Type ◽  
Cisterna Magna ◽  
Hindbrain Herniation ◽  
Ventricle Size ◽  
Idiopathic Syringomyelia ◽  
Fine Print

✓ Idiopathic syringomyelia, which is not associated with any definite pathogenic lesions, has been treated mainly by shunting of the syrinx and rarely by craniocervical decompression. The authors report four cases of syringomyelia thought to be idiopathic syringomyelia but treated by craniocervical decompression with favorable results. Syringomyelia was present without hindbrain herniation. In such cases, the subarachnoid space anterior to the brainstem at the level of the foramen magnum is usually open but the cisterna magna is impacted by the tonsils, a condition the authors term “tight cisterna magna.” All patients underwent foramen magnum decompression and C-1 laminectomy, and the outer layer of the dura was peeled off. Further intradural exploration was performed when outflow of cerebrospinal fluid (CSF) from the fourth ventricle was deemed to be insufficient. Postoperatively, improvement in symptoms and a reduction in syrinx size were demonstrated in three patients, and a reduction in ventricle size was shown in two. Syringomyelia associated with tight cisterna magna should not be classified as idiopathic syringomyelia; rather, it belongs to the category of organic syringomyelia such as Chiari malformation. A possible pathogenesis of cavitation is obstruction of the CSF outflow from the foramen of Magendie, and the cavity may be a communicating dilation of the central canal. Ventricular dilation may depend on the extent to which CSF drainage is impaired from the foramina of Luschka. These cavities may respond to craniocervical decompression if it results in sufficient CSF outflow from the foramen of Magendie, even in cases with concomitant hydrocephalus.

Anomaly of the axis causing cervical myelopathy

1999 ◽  
Vol 91 (1) ◽  
pp. 121-123 ◽  
Author(s):  
Hiroyuki Asakawa ◽  
Kiyoyuki Yanaka ◽  
Kiyoshi Narushima ◽  
Kotoo Meguro ◽  
Tadao Nose
Keyword(s):  
Spinal Cord ◽  
Cervical Myelopathy ◽  
Craniovertebral Junction ◽  
Posterior Arch ◽  
Cervical Canal ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Canal Stenosis ◽  
Remarkable Recovery ◽  
Fine Print

✓ Although the craniovertebral junction is one of the most common sites at which anomalies develop, spina bifida occulta of the axis (C-2) associated with cervical myelopathy is extremely rare. The authors present the case of a 46-year-old man who developed progressive tetraparesis caused by a cervical canal stenosis at the level of the axis. The spinal cord was compressed by an invaginated bifid lamina of the axis. The patient made a remarkable recovery after undergoing decompressive laminectomy of C-3 and removal of the bifid posterior arch of the axis.

Occipital-axis posterior wiring and fusion for atlantoaxial dislocation associated with occipitalization of the atlas

1993 ◽  
Vol 79 (1) ◽  
pp. 142-144 ◽  
Author(s):  
Vijendra K. Jain ◽  
Masakazu Takayasu ◽  
Satnam Singh ◽  
Devendra K. Chharbra ◽  
Kenichiro Sugita
Keyword(s):  
Posterior Margin ◽  
Early Mobilization ◽  
Foramen Magnum ◽  
Atlantoaxial Dislocation ◽  
Compression Force ◽  
Content Type ◽  
Degree Of Stability ◽  
High Degree ◽  
Very High ◽  
Fine Print

✓ The authors present their technique of occipital-axis posterior wiring and fusion for atlantoaxial dislocation associated with an occipitalized atlas. The technique consists of drilling a 3 × 1-cm horizontal groove in the occipital bone 1 cm posterior to the foramen magnum and building up a bony bridge along the posterior margin of the foramen magnum. This bony bridge is referred to as an “artificial atlas.” Conventional wiring and fusion is performed between the artificial atlas and the C-2 lamina, interposing a strut bone graft. Since the compression force on tightening the wire is vertical, a very high degree of stability for the occipital-C-2 complex is achieved, facilitating early mobilization without postoperative redislocation.

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