Postoperative paralysis following the surgery for thoracic ossification of the posterior longitudinal ligament: perioperative and intraoperative management strategies. Illustrative case

Postoperative paralysis in thoracic OPLL surgery remains poorly understood. Identifying and addressing risk factors for spinal cord ischemia and reperfusion injury are crucial. The authors propose strategies to reduce risk, including prone and supine position tests, the use of an ultrasonic surgical aspirator to prevent heat-induced spinal cord damage, shortening surgical duration, and meticulous blood pressure management. https://thejns.org/doi/10.3171/CASE25195.