Abstract：
OBJECTIVE: To describe a novel technique, posterior thoracic antidisplacement and fusion (PTAF), for a special type of ossification of the posterior longitudinal ligament in the thoracic spine (T-OPLL), and to evaluate its safety and efficacy.
METHODS: From July to December 2020, 5 consecutive patients with beak-type T-OPLL located at the thoracic vertebral body level underwent PTAF surgery. Their demographic data, radiological parameters, perioperative complications, and surgery-related findings were recorded and analyzed. The surgical outcomes were assessed using a modified Japanese Orthopedic Association scale, and the recovery rate was calculated using the Hirabayashi\'s method.
RESULTS: All patients were followed up for at least two years. The mean thickness of OPLL was 9.4 ± 1.0 mm, and the OPLL spinal canal occupying ratio was 67.7% ± 8.5%. Postoperatively, the mean antidisplacement distance of OPLL was 8.1 ± 1.8 mm, and the average shortened distance of the spinal column was 6.0 ± 1.13 mm. The mean operation time and blood loss were 158.2 ± 26.3 minutes and 460 ± 89.4 mL, respectively. Perioperative complications were cerebrospinal fluid leakage and instrument failure, 2 cases each. The mean modified Japanese Orthopedic Association score was increased from 3.6 ± 2.9 before surgery to 9.4 ± 3.0 at the last follow-up, and the average recovery rate was 84.2 ± 30.5%.
CONCLUSIONS: The preliminary clinical outcomes indicate that PTAF is a safe and effective method for the treatment of beak-type T-OPLL, which has its apex located at the vertebral body level and has a high spinal canal occupation ratio.
METHODS: From July to December 2020, 5 consecutive patients with beak-type T-OPLL located at the thoracic vertebral body level underwent PTAF surgery. Their demographic data, radiological parameters, perioperative complications, and surgery-related findings were recorded and analyzed. The surgical outcomes were assessed using a modified Japanese Orthopedic Association scale, and the recovery rate was calculated using the Hirabayashi\'s method.
RESULTS: All patients were followed up for at least two years. The mean thickness of OPLL was 9.4 ± 1.0 mm, and the OPLL spinal canal occupying ratio was 67.7% ± 8.5%. Postoperatively, the mean antidisplacement distance of OPLL was 8.1 ± 1.8 mm, and the average shortened distance of the spinal column was 6.0 ± 1.13 mm. The mean operation time and blood loss were 158.2 ± 26.3 minutes and 460 ± 89.4 mL, respectively. Perioperative complications were cerebrospinal fluid leakage and instrument failure, 2 cases each. The mean modified Japanese Orthopedic Association score was increased from 3.6 ± 2.9 before surgery to 9.4 ± 3.0 at the last follow-up, and the average recovery rate was 84.2 ± 30.5%.
CONCLUSIONS: The preliminary clinical outcomes indicate that PTAF is a safe and effective method for the treatment of beak-type T-OPLL, which has its apex located at the vertebral body level and has a high spinal canal occupation ratio.
摘要：
目的：描述一种新技术，胸椎后路前位和融合（PTAF），对于一种特殊类型的胸椎后纵韧带骨化（T-OPLL），并评估其安全性和有效性。
方法：从2020年7月至12月，连续5例位于胸椎椎体（VB）水平的喙型T-OPLL患者接受了PTAF手术。他们的人口统计数据,放射学参数，围手术期并发症,记录并分析手术相关结果.使用改良的日本骨科协会（mJOA）量表评估手术结果，回收率(RR)采用平林法计算。
结果：所有患者均随访至少2年。OPLL的平均厚度为9.4±1.0mm，OPLL椎管占用率为67.7%±8.5%。术后,OPLL的平均前位移距离为8.1±1.8mm，脊柱的平均缩短距离为6.0±1.13mm。平均手术时间和出血量分别为158.2±26.3min和460±89.4mL,分别。围手术期并发症为脑脊液漏和器械失效,各2例。平均mJOA评分从手术前的3.6±2.9增加到末次随访时的9.4±3.0。平均RR为84.2±30.5%。
结论：初步临床结果表明，PTAF是治疗喙型T-OPLL的一种安全有效的方法，其顶点位于VB水平，并具有较高的椎管占用率。
方法：从2020年7月至12月，连续5例位于胸椎椎体（VB）水平的喙型T-OPLL患者接受了PTAF手术。他们的人口统计数据,放射学参数，围手术期并发症,记录并分析手术相关结果.使用改良的日本骨科协会（mJOA）量表评估手术结果，回收率(RR)采用平林法计算。
结果：所有患者均随访至少2年。OPLL的平均厚度为9.4±1.0mm，OPLL椎管占用率为67.7%±8.5%。术后,OPLL的平均前位移距离为8.1±1.8mm，脊柱的平均缩短距离为6.0±1.13mm。平均手术时间和出血量分别为158.2±26.3min和460±89.4mL,分别。围手术期并发症为脑脊液漏和器械失效,各2例。平均mJOA评分从手术前的3.6±2.9增加到末次随访时的9.4±3.0。平均RR为84.2±30.5%。
结论：初步临床结果表明，PTAF是治疗喙型T-OPLL的一种安全有效的方法，其顶点位于VB水平，并具有较高的椎管占用率。
