Treatment of Anterior Approach to Upper Thoracic Spine Using Total Sternum Splitting

• Published in: Orthopedics & Traumatology Vol. 61; no. 3; pp. 513 - 517
• Main Authors: Nagata, Takehiro, Watanabe, Hiroyuki, Sagara, Taka-aki, Takemura, Kenichi, Kawatani, Yosuke, Seike, Ichiro, Akasaki, Koji, Tahata, Shogo
• Format: Journal Article
• Language: Japanese
• Published: West-Japanese Society of Orthopedics & Traumatology 2012
• Subjects: approach using total sternum splitting; ossification of posterior longitudinal ligament; upper thoracic spine
• ISSN: 0037-1033; 1349-4333
• DOI: 10.5035/nishiseisai.61.513

Ossification of the posterior longitudinal ligament (OPLL) of the upper thoracic spine occurs clinically less frequently than that of the cervical spine. However, thoracic OPLL causes severe myelopathy and surgical treatment becomes necessary. We experienced two cases of upper thoracic OPLL by anterior decompression using the total sternum spitting approach. Case 1: A 62-year-old female with OPLL of T2-3 underwent anterior decompression and fusion of T2-3 using total sternum splitting approach. Her myelopathy improved without critical complication. JOA score improved from four to eight points. Case 2: A 51-year-old female with OPLL of T1-3 underwent anterior decompression and fusion of T1-3 using total sternum splitting approach. Myelopathy improved without critical complication. JOA score improved from three to nine points. The surgical outcome of anterior decompression and fusion by total sternum splitting approach for upper thoracic OPLL was good. This approach has a low risk of the injury of the intra thoracic artery and is useful.