Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notes
Abstract Background Surgically managing multilevel thoracic ossification of the posterior longitudinal ligament (mT-OPLL) remains technically challenging. Recently, a novel technique called thoracic controllable antedisplacement and fusion (TCAF) has been proposed as an encouraging procedure for thi...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-025-06174-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849234848208650240 |
|---|---|
| author | Jiawen Niu Cheng Zhang Jie Zhao Yang Song Wen Xu Chuanhong Dou Chunzheng Gao Yachao Zhao Dongjin Wu |
| author_facet | Jiawen Niu Cheng Zhang Jie Zhao Yang Song Wen Xu Chuanhong Dou Chunzheng Gao Yachao Zhao Dongjin Wu |
| author_sort | Jiawen Niu |
| collection | DOAJ |
| description | Abstract Background Surgically managing multilevel thoracic ossification of the posterior longitudinal ligament (mT-OPLL) remains technically challenging. Recently, a novel technique called thoracic controllable antedisplacement and fusion (TCAF) has been proposed as an encouraging procedure for this disorder. This study aimed to offer evidence regarding the safety and efficacy of TCAF surgery through a case series of mT-OPLL patients treated with this new technique. Methods Between August 2021 and May 2025, 3 consecutive cases of mT-OPLL treated by the TCAF surgery were retrospectively reviewed, and their surgery-related data and complications were collected. Additionally, the modified Japanese Orthopedic Association (mJOA) score, American Spinal Injury Association (ASIA) grade, and imaging parameters, including the type, involved levels, maximal thickness (mT) and maximal occupation ratio (mOR) of T-OPLL, spinal canal area (SCA) and diameter (SCD) at the narrowest level, and antedisplacement distance (AD) of the thoracic column, were evaluated before surgery and/or at the final follow-up. Results TCAF surgeries were successfully conducted in all patients (1 male and 2 females), and the average surgical level, operation time, blood loss, and hospitalization length were 8.33 ± 1.53, 530.00 ± 105.36 min, 600.00 ± 100.00 ml, and 20.00 ± 6.25 days, respectively. The mean mT and T-OPLL were 7.73 ± 1.05 mm and 7.67 ± 2.08, respectively. The average AD was 5.90 ± 0.20 mm. At the last visit, each patient achieved solid bony fusion with improved mOR, SCA and SCD. The average mJOA scores at the final visit were relatively greater than that before the operation (8.00 ± 1.00 vs. 3.67 ± 1.15), with a mean recovery rate of 59.72 ± 8.67%. In addition, the ASIA grades at the last visit improved in 2 patients but remained unchanged in 1 patient. No neurological deterioration or other serious complications occurred postoperatively, except for 1 case of cerebrospinal fluid leakage. Conclusion The TCAF procedure, which allows canal decompression with no need for removal of T-OPLL, could be a promising surgical alternative for safely and effectively managing mT-OPLL. |
| format | Article |
| id | doaj-art-4b06a2ce2b404874b0bde2c735dfc0e5 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-4b06a2ce2b404874b0bde2c735dfc0e52025-08-20T04:03:01ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-08-012011910.1186/s13018-025-06174-4Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notesJiawen Niu0Cheng Zhang1Jie Zhao2Yang Song3Wen Xu4Chuanhong Dou5Chunzheng Gao6Yachao Zhao7Dongjin Wu8Department of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityDepartment of Spine Surgery, The Second Hospital of Shandong UniversityAbstract Background Surgically managing multilevel thoracic ossification of the posterior longitudinal ligament (mT-OPLL) remains technically challenging. Recently, a novel technique called thoracic controllable antedisplacement and fusion (TCAF) has been proposed as an encouraging procedure for this disorder. This study aimed to offer evidence regarding the safety and efficacy of TCAF surgery through a case series of mT-OPLL patients treated with this new technique. Methods Between August 2021 and May 2025, 3 consecutive cases of mT-OPLL treated by the TCAF surgery were retrospectively reviewed, and their surgery-related data and complications were collected. Additionally, the modified Japanese Orthopedic Association (mJOA) score, American Spinal Injury Association (ASIA) grade, and imaging parameters, including the type, involved levels, maximal thickness (mT) and maximal occupation ratio (mOR) of T-OPLL, spinal canal area (SCA) and diameter (SCD) at the narrowest level, and antedisplacement distance (AD) of the thoracic column, were evaluated before surgery and/or at the final follow-up. Results TCAF surgeries were successfully conducted in all patients (1 male and 2 females), and the average surgical level, operation time, blood loss, and hospitalization length were 8.33 ± 1.53, 530.00 ± 105.36 min, 600.00 ± 100.00 ml, and 20.00 ± 6.25 days, respectively. The mean mT and T-OPLL were 7.73 ± 1.05 mm and 7.67 ± 2.08, respectively. The average AD was 5.90 ± 0.20 mm. At the last visit, each patient achieved solid bony fusion with improved mOR, SCA and SCD. The average mJOA scores at the final visit were relatively greater than that before the operation (8.00 ± 1.00 vs. 3.67 ± 1.15), with a mean recovery rate of 59.72 ± 8.67%. In addition, the ASIA grades at the last visit improved in 2 patients but remained unchanged in 1 patient. No neurological deterioration or other serious complications occurred postoperatively, except for 1 case of cerebrospinal fluid leakage. Conclusion The TCAF procedure, which allows canal decompression with no need for removal of T-OPLL, could be a promising surgical alternative for safely and effectively managing mT-OPLL.https://doi.org/10.1186/s13018-025-06174-4AntedisplacementFusionMultilevelOssification of posterior longitudinal ligamentThoracic |
| spellingShingle | Jiawen Niu Cheng Zhang Jie Zhao Yang Song Wen Xu Chuanhong Dou Chunzheng Gao Yachao Zhao Dongjin Wu Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notes Journal of Orthopaedic Surgery and Research Antedisplacement Fusion Multilevel Ossification of posterior longitudinal ligament Thoracic |
| title | Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notes |
| title_full | Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notes |
| title_fullStr | Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notes |
| title_full_unstemmed | Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notes |
| title_short | Thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament: a case series with technical notes |
| title_sort | thoracic controllable antedisplacement and fusion in the treatment of multilevel thoracic ossification of the posterior longitudinal ligament a case series with technical notes |
| topic | Antedisplacement Fusion Multilevel Ossification of posterior longitudinal ligament Thoracic |
| url | https://doi.org/10.1186/s13018-025-06174-4 |
| work_keys_str_mv | AT jiawenniu thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT chengzhang thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT jiezhao thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT yangsong thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT wenxu thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT chuanhongdou thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT chunzhenggao thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT yachaozhao thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes AT dongjinwu thoraciccontrollableantedisplacementandfusioninthetreatmentofmultilevelthoracicossificationoftheposteriorlongitudinalligamentacaseserieswithtechnicalnotes |