BACKGROUND We evaluated the clinical, functional, and quality of life (QoL) outcomes of surgical treatment of thoracic ossification of the posterior longitudinal ligament (T-OPLL). METHODS We retrospectively evaluated 51 patients followed for ≥10 years after posterior decompression and corrective fusion surgery for T-OPLL. The data collected included demographics, comorbidities, and pre- and postoperative symptoms. The Japanese Orthopaedic Association (JOA) score, numerical rating scale (NRS) for back and leg pain, and EuroQol-5 Dimension-5 Level (EQ-5D-5L) were used to assess neurological function, pain, and QoL. Imaging evaluations were conducted to assess changes in kyphotic angles and ossification progression. RESULTS A significant improvement was observed in the JOA score from preoperatively (3.7) to 2 years postoperatively (7.9) (p < 0.05); the score remained stable thereafter. The mean EQ-5D-5L score improved from 0.53 preoperatively to 0.68 at 10 years postoperatively (p < 0.001). NRS scores for back and leg pain decreased from 5.4 to 3.5 and 4.0 to 3.0, respectively, from preoperatively to 10 years (p < 0.001 for both). Radiographic outcomes showed changes in kyphotic angles and ossification areas, with no significant progression after 2 years. Fourteen (27.5%) of the patients experienced postoperative complications. Of these, 8 (15.7%) required reoperation, 6 (11.8%) in the perioperative period and 2 (3.9%) later. Four (7.8%) of the patients underwent additional surgeries for conditions including lumbar spinal canal stenosis and cervical OPLL. Nonetheless, physical function in all cases with postoperative complications or additional surgery remained stable over the decade. CONCLUSIONS Surgical treatment of T-OPLL is effective in improving neurological function, QoL, and pain management over an extended period. The long-term outcomes of T-OPLL surgery revealed that, although cervical and lumbar spinal lesions led to reoperations, they did not affect QoL, and relative improvement was maintained even after 10 years. LEVEL OF EVIDENCE Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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胸椎后纵韧带骨化后路减压融合手术十年随访。


背景我们评估了胸椎后纵韧带骨化（T-OPLL）手术治疗的临床、功能和生活质量（QoL）结果。方法 我们回顾性评估了 51 例 T-OPLL 后路减压和矫正融合手术后随访≥10 年的患者。收集的数据包括人口统计、合并症以及术前和术后症状。使用日本骨科协会 (JOA) 评分、背部和腿部疼痛数字评定量表 (NRS) 和 EuroQol-5 Dimension-5 水平 (EQ-5D-5L) 来评估神经功能、疼痛和生活质量。进行影像学评估以评估后凸角的变化和骨化进展。结果 从术前 (3.7) 到术后 2 年 (7.9)，JOA 评分显着改善 (p < 0.05)；此后比分保持稳定。平均 EQ-5D-5L 评分从术前的 0.53 提高到术后 10 年的 0.68 (p < 0.001)。从术前到 10 年，背部和腿部疼痛的 NRS 评分分别从 5.4 下降到 3.5，从 4.0 下降到 3.0（两者的 p < 0.001）。放射学结果显示后凸角度和骨化区域发生变化，2 年后没有显着进展。 14 名患者（27.5%）出现术后并发症。其中，8 例（15.7%）需要再次手术，6 例（11.8%）在围手术期需要再次手术，2 例（3.9%）在围手术期后需要再次手术。其中 4 名患者（7.8%）因腰椎管狭窄和颈椎后纵韧带骨化等情况接受了额外手术。尽管如此，十年来，所有出现术后并发症或额外手术的病例的身体功能均保持稳定。 结论 T-OPLL 的手术治疗可有效长期改善神经功能、生活质量和疼痛管理。 T-OPLL手术的长期结果显示，虽然颈椎和腰椎病变导致再次手术，但并不影响生活质量，即使在10年后仍保持相对改善。证据级别 治疗级别 IV。有关证据级别的完整描述，请参阅作者须知。