Surgical Decompression of Thoracic Ossification of the Posterior Longitudinal Ligament through Posterior Approach: A Case Report.

Thoracic ossification of the posterior longitudinal ligament (OPLL) is a rare condition that is mainly accompanied by cervical OPLL or ossification of thoracic ligamentum flavum. In case of causing neurological manifestations, it is preferred to treat the condition surgically. Several surgical procedures were introduced, including anterior, posterior, or combined approaches. Laminectomy with instrumented fusion is the most popular procedure utilized via the posterior approach. A 32-year-old obese woman, who suffered from back pain and weakness in both lower extremities for one month, was referred to our spine outpatient clinic. Imaging revealed lower thoracic OPLL (T7/T8 & T8/T9 & T9/T10). The posterior longitudinal ligament had a mixed ossification pattern (beaked and continuing cylindrical). To maintain thoracic spine stability and prevent future kyphosis, we performed laminectomy and long segment fixation (T7 to T12). The post-operative neurological examination revealed a considerable increase in muscle strength and significant pain relief.

Surgical Management of Adult Traumatic Atlantoaxial Rotatory Fixation with Hangman Fracture: Case Report and Literature Review.

Atlantoaxial rotatory fixation (AARF) is a rare type of adult cervical spine injury. The classic symptoms are painful torticollis and limited neck range of motion. To avoid catastrophic consequences, early diagnosis is necessary. The present study presents the successful treatment of a scarce case of adult AARF with a Hangman fracture and a comprehensive literature review. A 25-year-old man presented to the trauma bay with left-sided torticollis after a motor vehicle accident. Cervical computed tomography scans revealed type I AARF. Torticollis resolved after cervical traction with partial reduction, and posterior C1-C2 fusion was performed as part of the therapy. Recognition of AARF after trauma requires a high index of suspicion, and early diagnosis is critical for the achievement of the best possible patient outcomes. Since the combination of a Hangman fracture and C1-C2 rotatory fixation is complex and unique, it must be tailored to the associated injuries.