Kanno Haruo, Takahashi Tadahisa, Aizawa Toshimi, Hashimoto Ko, Itoi Eiji, Ozawa Hiroshi
Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan.
Eur Spine J. 2018 Jul;27(Suppl 3):359-367. doi: 10.1007/s00586-017-5281-6. Epub 2017 Aug 24.
Ossification of the ligamentum flavum (OLF) is a possible cause of thoracic myelopathy. We report two rare cases with recurrent thoracic myelopathy caused by OLF markedly re-extended at the same intervertebral level after the primary surgery.
Both patients had thoracic myelopathy caused by OLF and underwent decompressive laminectomy and resection of the OLF in the primary surgery. However, the neurological conditions gradually deteriorated following recovery after the primary surgery due to the recurrent OLF at the same intervertebral level.
These patients were successfully treated by revision surgery via resection of the recurrent OLF and posterior spinal fusion with instrumentation. Two years after the second surgery, the neurological disturbance was resolved satisfactorily, and re-growth of the resected ossified lesion was not observed.
The recurrence of OLF following resection of the ossified lesions is exceedingly rare but should be noted in patients treated surgically for thoracic myelopathy due to OLF.
黄韧带骨化（OLF）是胸段脊髓病的一个可能病因。我们报告两例罕见病例，其因OLF导致复发性胸段脊髓病，在初次手术后同一椎间水平黄韧带明显重新骨化。
两名患者均因OLF导致胸段脊髓病，并在初次手术中接受了减压椎板切除术和OLF切除术。然而，由于同一椎间水平的OLF复发，初次手术后恢复过程中神经状况逐渐恶化。
这些患者通过再次手术成功治疗，再次手术包括切除复发性OLF并进行后路脊柱融合内固定术。第二次手术后两年，神经功能障碍得到满意解决，未观察到切除的骨化病变重新生长。
骨化病变切除后OLF复发极为罕见，但对于因OLF接受手术治疗的胸段脊髓病患者应予以关注。
