Compressive myelopathy due to ossified yellow ligament among South Asians: analysis of surgical outcome.

摘要

BACKGROUND: Ossified yellow ligament (OYL) is a rare, disabling cause of extradural compressive radiculomyelopathy, responding poorly to surgical intervention. METHODS: From January 1999 to December 2008, 16 patients (male/female, 11/5; mean age, 45.7 years; median, 44.5 years) harbouring symptomatic OYL were managed at our center. Radiological investigations including computerised tomography and magnetic resonance imaging scans were performed before undertaking surgical intervention. High-speed drills and operating microscope were put to use in excising these pathological ligaments. RESULTS: At median follow-up of 16.5 months, all patients had improved to better clinical status. The spasticity was the most resistant to recovery, while motor power improved in 13 cases. Intra-operatively, dural ossification was noted in 50% of the cases, requiring repair or prophylactic cerebrospinal fluid drainage. CONCLUSIONS: The surgical technique of drilling and yellow ligament excision needs precision. Patients with poor neurological status may also benefit from surgical decompression and should be offered the option of surgery.