Balancing Efficacy and Safety for Non-ambulatory Thoracic OPLL: Superior Mobility with Circumferential Decompression...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Cord Research

Background:

• Thoracic ossification of the posterior longitudinal ligament (T-OPLL) often leads to non-ambulatory status.
• Surgical outcomes and predictors of recovery in this specific patient group require further elucidation.

Purpose of the Study:

• To detail clinical characteristics and surgical outcomes for non-ambulatory T-OPLL patients.
• To identify factors predicting independent walking recovery after surgery.

Main Methods:

• Retrospective cohort study of 70 non-ambulatory T-OPLL patients (2012-2022).
• Comparison of circumferential decompression (CD) versus posterior decompression with fusion (PDF) surgical techniques.
• Analysis of neurological recovery, independent walking, and complication rates.

Main Results:

• 71.4% of patients regained independent walking post-surgery.
• Circumferential decompression (CD) demonstrated superior walking recovery (90%) but higher complication rates (70%) compared to PDF (64% walking recovery, 38% CSF leakage).
• Shorter disease duration and lower BMI were independent predictors of better walking recovery.

Conclusions:

• CD surgery offers enhanced functional recovery for non-ambulatory T-OPLL patients, while PDF surgery presents a safer option.
• Early surgical intervention and tailored treatment based on disease duration and BMI are crucial for optimizing walking recovery.
• Further research into T-OPLL surgical management is warranted.