Opll: Ossification Of The Posterior Longitudinal Ligament Ossification Of The Posterior Longitudinal Ligament

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. Cover ......Page 1 Contents......Page 9 Contributors......Page 12 1. Introduction......Page 18 History of Research......Page 19 2. Epidemiology......Page 21 Overview of Epidemiology and Genetics......Page 22 OPLL - Disease Entity, Incidence, Literature Search, and Prognosis......Page 25 Genetic Susceptibility to OPLL......Page 32 Overview of Etiology and Pathogenesis......Page 39 Etiology and Pathogenesis......Page 42 Contribution of Metabolic Conditions to Ossification of the Posterior Longitudinal Ligament of the Spine......Page 45 Review of Histopathological Studies on OPLL of the Cervical Spine, with Insights into the Mechanism......Page 49 Pathology of Ossification of the Ligamentum Flavum......Page 56 Possible Roles of Bone Morphogenetic Proteins and Transforming Growth Factor-bs in the Pathogenesis of OPLL and OLF......Page 65 3. Pathology and Pathogenesis......Page 70 Pathology of Spinal Cord Lesions Caused by Ossification of the Posterior Longitudinal Ligament......Page 71 Tiptoe Walking ( ttw ) Mouse......Page 77 Study of Ligament Ossification and Abnormal Glucose Tolerance in the Zucker Fatty Rat......Page 82 Experimental Murine Model of Ossification of Spinal Ligaments Induced by Bone Morphogenetic Protein-2......Page 97 Spinal Cord Lesions in Spinal Hyperostotic Mouse (twy/twy) Simulating Ossification of the Posterior Longitudinal Ligament of the Cervical Spine......Page 105 4. Diagnosis of OPLL and OYL......Page 112 Diagnosis of OPLL and OYL - Overview......Page 113 Clinical Manifestation of Cervical OPLL......Page 116 Clinical Manifestations of Thoracic OPLL and OLF......Page 121 Diagnostic Imaging of Cervical Ossification of the Posterior Longitudinal Ligament......Page 126 Imaging Diagnosis of Thoracic OPLL and OLF......Page 143 Electrophysiological Diagnosis of Cervical OPLL Myelopathy......Page 149 5. Treatment of OPLL and OLF......Page 160 Overview of Treatment for Ossification of the Longitudinal Ligament and the Ligamentum Flavum......Page 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 Surgery......Page 164 Conservative Treatment of Ossification of the Posterior Longitudinal Ligament in the Cervical Spine......Page 172 Choice of Surgical Procedure......Page 176 Expansive Laminoplasty......Page 181 Expansive Open-door Laminoplasty for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine: Surgical Indications, Technique, and Outcomes......Page 186 Double-door Laminoplasty by Splitting Spinous Processes......Page 193 Anterior Cervical Decompression for Cervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament......Page 200 Treatment of OPLL and OLF of the Cervical Spine - Long-Term Results......Page 210 Choice of Surgical Procedures for Thoracic Ossification of the Posterior Longitudinal Ligament......Page 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......Page 221 Circumspinal Decompression with Dekyphosis Stabilization for Thoracic Myelopathy due to Ossification of the Posterior Longitudinal Ligament......Page 225 Posterior Extensive Cervicothoracic Laminoplasty......Page 231 Anterior Decompression Through Posterior Approach for Thoracic Myelopathy Caused by OPLL - Ohtsuka Procedure......Page 238 Surgical Treatment for Ossification of the Posterior Longitudinal Ligament of the Thoracic Spine: Outcomes of One-Stage Posterior Decompression with Corrective Fusion Surgery......Page 248 Surgery for Ossification of the Ligamentum Flavum......Page 254 Computer-Aided Surgery for Ossification of the Spinal Ligaments......Page 259 Surgical Treatment of Thoracic Ossification of the Posterior Longitudinal Ligament - Intraoperative Spinal Cord Monitoring......Page 267 Intraoperative Ultrasonography for Patients with Ossification of the Posterior Longitudinal Ligament......Page 275 Appendix......Page 286 Subject Index......Page 290 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. What is OPLL? How it should be treated? This illustrated volume provides information on various aspects of OPLL - epidemiology, etiology, diagnosis, and treatment - which is of special interest to orthopedic surgeons and neurosurgeons, as well as to neurologists, rheumatologists, neuroradiologists, and pathologists K. Yonenobu, K. Nakamura, Y. Toyama (eds.). Includes Bibliographic References And Index.