Anterior Surgery in Selective Patients with Massive Ossification of Posterior Longitudinal Ligament of Cervical Spine: Technical Note

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2011 Sep 1

PMID 21879414

Citations 17

Authors

Xinwei Wang

Deyu Chen

Wen Yuan

Ying Zhang

Jianru Xiao

Jie Zhao

Affiliations

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Abstract

Study Design: The study includes case series, technical note and review of literature.

Objective: The objective of this study was to assess the validity of the radiographic indicator and the result of anterior operation for massive ossification of posterior longitudinal ligament (MOPLL, ossification of posterior longitudinal ligament with an occupying ratio exceeding 50%). Anterior decompression yielded a better outcome than posterior approach in patients with MOPLL of cervical spine. But anterior surgery has the problem of technically demanding and was associated with a high incidence of surgery-related complications. Many ways for reducing the risk of anterior surgery have been reported, including floating method, employing microscopes or burrs, and laser-assisted corpectomy.

Materials And Methods: A case series of selective patients with MOPLL of cervical spine undergoing anterior surgery is reported. All patients were strictly selected based on CT images with the appearance of open-base. 29 cases with more than 12 months follow-up (average, 31.0 ± 10.0 m) were reviewed. Average age at operation was 59.3 ± 8.2 years (43-73 years). Anterior decompression was done only for one or two vertebrae.

Results: One corpectomy was done in 13 cases, two corpectomies in 3 cases, and one corpectomy and one discectomy in 13 cases. Three levels were fused in 16 cases and two levels in 13 cases. No permanent neurological deterioration was observed. Neurological improvement was observed in every patients with an average improvement rate of 64 ± 23%. Mesh migration was observed in one case. A fusion rate of 100% was achieved.

Conclusion: Anterior surgery using our technique may be a relatively simple and safe procedure in selective patients with massive ossification of posterior longitudinal ligament of cervical spine.

Citing Articles

An Algorithmic Roadmap for the Surgical Management of Degenerative Cervical Myelopathy: A Narrative Review.

Lee D, Lee H, Riew K Asian Spine J. 2023; 18(2):274-286.

PMID: 38146052 PMC: 11065509. DOI: 10.31616/asj.2023.0413.

Anterior Decompression and Fusion for the Treatment of Cervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: A Narrative Review.

Park S, Lee D, Lee C, Hwang C, Yang J, Cho J Asian Spine J. 2023; 17(3):582-594.

PMID: 36647198 PMC: 10300897. DOI: 10.31616/asj.2022.0003.

Comparison of the surgeries for the ossification of the posterior longitudinal ligament-related cervical spondylosis: A PRISMA-compliant network meta-analysis and literature review.

Li S, Peng J, Xu R, Zheng R, Huang M, Xu Y Medicine (Baltimore). 2021; 100(9):e24900.

PMID: 33655951 PMC: 7939206. DOI: 10.1097/MD.0000000000024900.

Risk factors of cage nonunion after anterior cervical discectomy and fusion.

Ren B, Gao W, An J, Wu M, Shen Y Medicine (Baltimore). 2020; 99(12):e19550.

PMID: 32195963 PMC: 7220066. DOI: 10.1097/MD.0000000000019550.

How to Avoid Postoperative Remaining Ossification Mass in Anterior Controllable Antedisplacement and Fusion Surgery.

Sun J, Xu X, Wang Y, Yuan X, Shi J, Yang H World Neurosurg X. 2019; 3:100034.

PMID: 31225525 PMC: 6584598. DOI: 10.1016/j.wnsx.2019.100034.

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