OLF Combined with OPLL or Vertebral Fracture Asian Spine Journal 1 Surgical Results of Patients with Myelopathy due to Ossifcation of the Ligamentum Flavum with Ossifcation of the Posterior Longitudinal Ligament or a Vertebral Fracture at the Same Level of the Toracic Spine: A Retrospective Comparative Study Yuji Kasukawa, Naohisa Miyakoshi, Michio Hongo, Yoshinori Ishikawa, Daisuke Kudo, Ryota Kimura, Yuichi Ono, Jumpei Iida, Chiaki Sato, Yoichi Shimada Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan Study Design: Retrospective and comparative study. Purpose: We assessed surgical treatment outcomes in patients with thoracic myelopathy due to ossifcation of the ligamentum favum (OLF), and OLF combined with ossifcation of the posterior longitudinal ligament (OPLL) or vertebral fracture (VF) at the same level. Overview of Literature: OLF and OPLL cause severe thoracic myelopathy. Osteoporotic VF commonly occurs at the thoracolumbar junction. There have been no investigations of thoracic myelopathy due to OLF and VF. Methods: Forty patients were divided among three groups: the OLF group (n=23): myelopathy due to OLF, the OLF+OPLL group (n=12): myelopathy due to OLF and OPLL, and the OLF+VF group (n=5): myelopathy due to OLF and VF. We recorded OLF, OPLL, and VF sites and operative procedures. Each patient’s neurological status, according to the Japanese Orthopaedic Association (JOA) score, and walking ability were evaluated pre- and postoperatively. Results: Patients in the OLF+OPLL group were significantly younger than those in the other two groups. The preoperative JOA score was signifcantly lower in the OLF+VF than OLF group. The fnal JOA score was signifcantly lower in the OLF+VF than OLF and OLF+OPLL groups. The JOA score recovery rate was signifcantly lower in the OLF+VF than OLF group. Final walking ability was signif- cantly worse in the OLF+OPLL and OLF+VF groups than in the OLF group and signifcantly worse in the OLF+VF than OLF+OPLL group. Conclusions: Thoracic myelopathy due to OLF+VF occurs primarily in older females, who also exhibit worse preoperative and postop- erative neurological status, and worse walking ability, than patients with thoracic myelopathy due to OLF or OLF+OPLL. Keywords: Ligamentum favum ossifcation; Posterior longitudinal ligament ossifcation; Osteoporotic fracture; Compression fracture; Myelopathy Copyright Ⓒ 2019 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Asian Spine Journal • pISSN 1976-1902 eISSN 1976-7846 • www.asianspinejournal.org Received Oct 27, 2018; Revised Dec 19, 2018; Accepted Jan 10, 2019 Corresponding author: Yuji Kasukawa Department of Orthopedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan Tel: +81-18-884-6148, Fax: +81-18-836-2617, E-mail: kasukawa@doc.med.akita-u.ac.jp ASJ Clinical Study Asian Spine J. June 3, 2019 [Epub ahead of print] • htps://doi.org/10.31616/asj.2018.0278 Asian Spine Journal