Spine Center, Matsudo City Hospital, 4005 Kamihongo, Matsudo 271-8511, Japan.
Spine J. 2013 Aug;13(8):e7-9. doi: 10.1016/j.spinee.2013.02.013. Epub 2013 Mar 13.
Although complete resection is the preferred surgical treatment for ossification of the ligamentum flavum (OLF), it sometimes results in the floating method because of adhesion to, or ossification of, the dura mater. It is difficult to anticipate the degree of floating, and if the floated ossification is large, decompression of the spinal cord may not be sufficient.
To describe a case of spontaneous reduction of a floated OLF after posterior decompression.
Case report and review of the literature.
A 70-year-old woman with OLF of the thoracic spine presented with gait disturbance. A computed tomographic myelogram showed a large ossification and severe spinal canal stenosis at T10-T11. It also showed slight spinal cord compression by ossification at T9-T10.
We performed a laminectomy with floating ossification at T9-T11 and posterior fusion with a pedicle screw system at T10-T11. After the operation, the patient's neurologic improvement was excellent. Five weeks after the operation, a computed tomogram showed reduction of the floated ossification. Improvement progressed up to 3 months after the operation, bringing a sufficient decompression of the spinal cord, whereas it was insufficient immediately after the operation.
Our present study is the first report that showed OLF was reduced after the floating method. Reduction of the floated ossification was observed 5 weeks after the operation.
尽管完全切除是治疗黄韧带骨化（OLF）的首选手术方法，但由于与硬脑膜粘连或骨化，有时会采用浮动法。难以预测浮动的程度，如果浮动的骨化较大，脊髓减压可能不足。
描述一例后路减压后自发复位的游离 OLF 病例。
病例报告和文献复习。
一名 70 岁女性患有胸椎 OLF，表现为步态障碍。CT 脊髓造影显示 T10-T11 处有较大的骨化和严重的椎管狭窄。T9-T10 处的骨化也对脊髓造成轻微压迫。
我们在 T9-T11 处进行了椎板切除术和游离骨化，在 T10-T11 处进行了带蒂螺钉系统的后路融合。术后，患者的神经功能改善非常明显。术后 5 周，CT 显示游离骨化复位。术后 3 个月内病情持续改善，脊髓得到充分减压，但术后即刻减压不足。
我们的研究是首例报道游离法后 OLF 复位的病例。术后 5 周观察到游离骨化的复位。
