Question:I'm going to have surgery to remove part of the big ligament along the back of my spine. The section from T6 to T8 has turned to bone. The surgeon has warned me that paralysis is a possibility with this operation. Can I do anything ahead of time to prevent this from happening?
Answer:Paralysis is a major risk after surgery of this type. Unfortunately, there isn't anything you can do personally to affect the outcome.
Research shows that several factors come into play here. The thoracic spine tends to be slightly flexed or bent forward. This position is called kyphosis. If a laminectomy is done (bone cut away from the spine), then pressure is taken off the ligament. This ligament is the posterior longitudinal ligament. After a thoracic laminectomy, the spinal cord tends to shift backward. This increases the risk of spinal cord compression and paralysis. The ribs also get in the way when doing the surgery.
The surgeon must be very careful not to damage the spinal cord during surgery. Some surgeons advise doing a spinal fusion after laminectomy to keep the thoracic spine in a more erect position. This has been shown to prevent paralysis on a long-term basis.Masashi Yamazaki, MD, PhD, et al. Clinical Results of Surgery for Thoracic Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: Operative Indication of Posterior Decompression with Instrumented Fusion. In Spine. June 1, 2006. Vol. 31. No. 13. Pp. 1452-1460.
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