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One-stage combined decompression for cervical ossification of the posterior longitudinal ligament combined with upper thoracic ossification of the ligamentum flavum: Case report

Background and objective: Ossification of posterior longitudinal ligament (OPLL) and ossification of ligamentum flavum (OLF) are common clinical heterotopic ossification diseases and are the main causes of cervicothoracic spinal stenosis and spinal cord damage. However, the incidence of cervical OPLL combined with thoracic OLF is unclear, this clinical condition is difficult to treat, and the surgical approach is not fully established. We report two cases of patients with cervical OPLL combined with upper thoracic OLF treated with one-stage combined decompression Methods: The clinical data of 2 patients diagnosed with cervical OPLL combined with upper thoracic OLF (T1-3) and one-stage surgical treatment from January 2015 to January 2019 were analyzed. Results: Two patients underwent one-stage combined decompression surgery, and the surgery was successfully completed, and there were no postoperative complications such as cerebrospinal fluid leakage and neurological deterioration. One patient’s JOA score increased from 5 points before surgery to 11 points at 2 years of follow-up, and the improvement rate of JOA score was 50%; Another patient’s JOA score increased from 11 points before surgery to 15 points at 2 years of follow-up, and the improvement rate of JOA score was 66.7%. Two patients were satisfied with postoperative recovery. Conclusion: There are few reports on cervical OPLL combined with upper thoracic OLF. We report two cases of patients with cervical OPLL combined with upper thoracic OLF treated with one-stage combined decompression. The postoperative results were satisfactory. However, there were only 2 patients in this study and the follow-up period was short, in the future, high-quality studies with large samples, randomization, and long-term follow-up are still needed to further verify our conclusions