{
  "abstract": "Multilevel thoracic ossification of the posterior longitudinal ligament (T-OPLL), especially when it involves more than five consecutive vertebrae, remains surgically challenging. In recent years, a strategy focused on \"spinal cord de-tension\" has been proposed for such extensive involvements. This report describes a 52-year-old woman who presented with progressive thoracic myelopathy due to continuous OPLL from T3 to T10, causing severe canal stenosis. The surgical approach included a posterior laminectomy from T4 to T10, circumferential decompression at the most compressed level (T8-9), and long-segment instrumentation from T3 to T11. A postoperative cerebrospinal fluid leak was suspected but managed conservatively with controlled drainage and bed rest. By the 12-month follow-up, the patient's neurological status had improved markedly: her modified Japanese Orthopaedic Association (mJOA) score rose from 5 to 10, corresponding to a Hirabayashi recovery rate of 83.3%. Radiographs showed adequate decompression, solid fusion, and no implant failure. Taken together, for symptomatic, ultra-long segment T-OPLL, posterior circumferential decompression combined with long-segment fusion under the spinal cord de-tension principle appears to be highly effective. Spinal shortening achieved through parallel osteotomy and compression provides indirect longitudinal de-tension, complementing direct ventral decompression while maintaining stability. Careful surgical technique and systematic management of complications like cerebrospinal fluid leakage remain essential for a good outcome. This approach offers a favorable risk-benefit balance in these complex cases.",
  "abstract_shown": true,
  "affiliations": [
    "Joint Sports Medicine Department, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China.",
    "Neurosurgery Department, China-Japan Friendship Hospital, Beijing, China.",
    "Orthopedic Department, Peking University Third Hospital, Beijing, China.",
    "Department of Hand, Foot and Vascular Surgery, Peking University Shenzhen Hospital, Shenzhen, China.",
    "Department of Bone and Joint, Liwan District Orthopedic and Traumatology Hospital, Guangzhou, China."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lei Ren"
    },
    {
      "affs": [
        1
      ],
      "name": "Hongju Liu"
    },
    {
      "affs": [
        2
      ],
      "name": "Chuiguo Sun"
    },
    {
      "affs": [
        3
      ],
      "name": "Jieyu Liang"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Chao Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Weiye Ti"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cyrz851c9cvmt.bib",
  "cited_by": 0,
  "doi": "10.3389/fsurg.2026.1912076",
  "fulltext_url": "https://europepmc.org/articles/PMC13682520",
  "id": "cyrz851c9cvmt",
  "issns": [
    "2296-875X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42904212",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Cervical and Thoracic Myelopathy"
    ]
  ],
  "openalex": "W7220692256",
  "pdf_url": "https://europepmc.org/articles/PMC13682520?pdf=render",
  "pmcid": "PMC13682520",
  "pmid": "42904212",
  "published": "2026-10-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cyrz851c9cvmt.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42904212",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42904212"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Cervical and Thoracic Myelopathy",
      "subfield": "surgery"
    }
  ],
  "title": "Posterior circumferential decompression for multilevel thoracic ossification of the posterior longitudinal ligament: a case report and literature review.",
  "title_text": "Posterior circumferential decompression for multilevel thoracic ossification of the posterior longitudinal ligament: a case report and literature review.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/cyrz851c9cvmt",
  "venue": "Frontiers in surgery",
  "versions": []
}