Choice of Surgical Procedure for Thoracic Ossification of the Posterior Longitudinal Ligament and Ossification of the Ligamentum Flavum

The prevalence of thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) or by ossification of the ligamentum flavum (OLF) is less than that of cervical myelopathy caused by cervical OPLL. However, once compressive myelopathy has appeared at the thoracic spine, which is mechanically more stable than other spinal levels by nature, conservative treatment such as rest or immobilization by a brace is considered to be ineffective [1-3]. Accordingly, decompressive surgery should be recommended for patients with severe or moderate thoracic myelopathy caused by OPLL or OLF.