The bridge crane technique for the treatment of the severe thoracic ossification of the ligamentum flavum with myelopathy

This study aims to investigate the clinical effect and complications of a novel technique named bridge crane for the treatment of the severe thoracic ossification of the ligamentum flavum (TOLF) with myelopathy. A patient diagnosed as TOLF (T9–T11) was treated with the bridge crane technique and the outcomes were reported. The main surgical procedures include installation of pedicle screws, rods and transverse connectors; preparation of stay prolene sutures passing through the laminae-OLF complex (LOC); en bloc isolation of the LOC; tightening of the sutures to achieve posterior suspension of the LOC; and fixation of the LOC to the transverse connectors. The modified Japanese Orthopaedic Association (mJOA) scale was studied. The pre- and postoperative radiological parameters and surgical complications were also investigated. Postoperative CT and MRI showed a sufficient decompression of spinal cord by the technique of bridge crane. The ratio of spinal canal encroachment improved significantly. At the final follow-up assessment, no specific complications were identified. Imaging information suggested that the bone graft was fused and the “bridge” was in good position. The mJOA score was 9 with a recovery rate of 75% at the final follow-up. The technique of bridge crane is feasible and may be relatively safe and effective for the treatment of severe TOLF with myelopathy. However, further studies with large-scale cases and control groups are required to reveal the generalizability and safety of the bridge crane technique in the future. These slides can be retrieved under Electronic Supplementary Material.