OPLL (eBook)

Ossification of the Posterior Longitudinal Ligament
eBook Download: PDF
2007 | 2nd ed. 2006
XVIII, 305 Seiten
Springer Tokyo (Verlag)
978-4-431-32563-5 (ISBN)

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This publication brings together information on all aspects of OPLL - epidemiology, etiology, diagnosis, and treatment. It contains contributions by Japanese researchers and surgeons, including members of the Ministry of Health and Welfare Investigation Committee, and by American surgeons with expertise in the field. Until now, little has been published on the subject in English. This collection of reports is amply augmented with illustrations.


Ossification of the posterior longitudinal ligament (OPLL) is a hyperostotic condition of the spine with severe neurological deficits. In 1975 the Investigation Committee for OPLL, under the auspices of the Japanese Ministry of Health and Welfare, established diagnostic criteria for the condition, and with growing awareness of OPLL among Japanese researchers and spinal surgeons, the number of patients diagnosed with the condition in Japan has increased in recent years. As knowledge of OPLL has spread, there has also been an increase in the number of reported cases of the condition in other parts of the world: Asia, the United States, and Europe. Until now, however, little has been published on the subject in English; thus the appearance of this present volume is most timely. It brings together information on all aspects of OPLL - epidemiology, etiology, diagnosis, and treatment - with contributions by Japanese researchers and surgeons, including members of the Ministry of Health and Welfare Investigation Committee, and by American surgeons with expertise in the field. This collection of reports on OPLL, amply augmented with illustrations, will be of special interest to orthopedic surgeons and neurosurgeons, and to neurologists, rheumatologists, neuroradiologists, and pathologists.

Preface to the Second Edition 5
Preface to the First Edition 7
Contents 9
Contributors 12
Introduction 18
History of Research 19
Epidemiology 21
Overview of Epidemiology and Genetics 22
OPLL: Disease Entity, Incidence, Literature Search, and Prognosis 25
Genetic Susceptibility to OPLL 32
Pathology and Pathogenesis 39
Overview of Etiology and Pathogenesis 40
Etiology and Pathogenesis 43
Contribution of Metabolic Conditions to Ossification of the Posterior Longitudinal Ligament of the Spine 46
Review of Histopathological Studies on OPLL of the Cervical Spine, with Insights into the Mechanism 50
Pathology of Ossification of the Ligamentum Flavum 57
Possible Roles of Bone Morphogenetic Proteins and Transforming Growth Factor- bs in the Pathogenesis of OPLL and OLF 66
Pathology of Spinal Cord Lesions Caused by Ossification of the Posterior Longitudinal Ligament 71
Tiptoe Walking (ttw) Mouse 77
Study of Ligament Ossification and Abnormal Glucose Tolerance in the Zucker Fatty Rat 82
3 6 9 12 3 6 9 12 86
Experimental Murine Model of Ossification of Spinal Ligaments Induced by Bone Morphogenetic Protein- 2 97
Spinal Cord Lesions in Spinal Hyperostotic Mouse ( twy/ twy) Simulating Ossification of the Posterior Longitudinal Ligament of the Cervical Spine 105
Diagnosis of OPLL and OYL 112
Diagnosis of OPLL and OYL: Overview 113
Clinical Manifestation of Cervical OPLL 116
Clinical Manifestations of Thoracic OPLL and OLF 121
Diagnostic Imaging of Cervical Ossification of the Posterior Longitudinal Ligament 126
Imaging Diagnosis of Thoracic OPLL and OLF 143
Electrophysiological Diagnosis of Cervical OPLL Myelopathy 149
Treatment of OPLL and OLF 160
Overview of Treatment for Ossification of the Longitudinal Ligament and the Ligamentum Flavum 161
Pharmacotherapy for Ossification of the Spinal Ligaments: Clinical Trial of Disodium ( 1- Hydroxyethylidene) Diphosphonate to Inhibit Progression of Ossification of the Posterior Longitudinal Ligament in the Cervical Spine after Posterior Decompression S 164
Conservative Treatment of Ossification of the Posterior Longitudinal Ligament in the Cervical Spine 172
Choice of Surgical Procedure 176
Expansive Laminoplasty 181
Expansive Open-door Laminoplasty for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine: Surgical Indications, Technique, and Outcomes 186
Double-door Laminoplasty by Splitting Spinous Processes 193
Anterior Cervical Decompression for Cervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament 200
Treatment of OPLL and OLF of the Cervical Spine: Long- Term Results 210
Choice of Surgical Procedures for Thoracic Ossification of the Posterior Longitudinal Ligament 215
Anterior Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament of the Thoracic Spine: Procedure and Clinical Outcomes of Transthoracic and Transsternal Approaches 221
Circumspinal Decompression with Dekyphosis Stabilization for Thoracic Myelopathy due to Ossification of the Posterior Longitudinal Ligament 225
Posterior Extensive Cervicothoracic Laminoplasty 231
Anterior Decompression Through Posterior Approach for Thoracic Myelopathy Caused by OPLL: Ohtsuka Procedure 238
Surgical Treatment for Ossification of the Posterior Longitudinal Ligament of the Thoracic Spine: Outcomes of One- Stage Posterior Decompression with Corrective Fusion Surgery 248
Surgery for Ossification of the Ligamentum Flavum 254
Computer-Aided Surgery for Ossification of the Spinal Ligaments 259
Surgical Treatment of Thoracic Ossification of the Posterior Longitudinal Ligament: Intraoperative Spinal Cord Monitoring 267
Intraoperative Ultrasonography for Patients with Ossification of the Posterior Longitudinal Ligament 275
Appendix: Diagnostic Criteria for OPLL and Diagnosis and Treatment Algorithm 286
Subject Index 290

Erscheint lt. Verlag 15.1.2007
Zusatzinfo XVIII, 305 p. 280 illus.
Verlagsort Tokyo
Sprache englisch
Themenwelt Medizinische Fachgebiete Chirurgie Neurochirurgie
Medizinische Fachgebiete Chirurgie Unfallchirurgie / Orthopädie
Medizinische Fachgebiete Innere Medizin Rheumatologie
Medizin / Pharmazie Medizinische Fachgebiete Orthopädie
Schlagworte Bone • clinical trial • Decompression • Imaging • Myelopathy • Ossfication of the posterior logitudinal ligament • Pathology • sonography • spinal cord • spine • Surgery
ISBN-10 4-431-32563-8 / 4431325638
ISBN-13 978-4-431-32563-5 / 9784431325635
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