Recurrent ossification of the posterior longitudinal ligament in the upper thoracic region 10 years after initial decompression

BACKGROUND: Posterior decompression surgery consisting of laminoplasty is generally considered be the treatment of choice for upper thoracic OPLL. Here, we describe a patient who, 10 years following a C3–T4 level laminectomy, developed recurrent OPLL at the T2–3 level with kyphosis requiring a posterior fusion. CASE DESCRIPTION: A 64-year-old male with CT documented OPLL at the C3–4, C6–7, and T1–4 levels, originally underwent a cervicothoracic laminectomy with good results. However, 10 years later, when T2–3 OPLL recurred along with kyphosis, he warranted an additional posterior fusion. CONCLUSION: Due to the long-term risks of developing kyphotic deformity/instability, more patients undergoing initial decompressive surgery alone for upper thoracic OPLL should be considered for primary fusions.