» Articles » PMID: 39579009

Improved Function After Anterior Controllable Antedisplacement and Fusion for Cervical Ossification of Posterior Longitudinal Ligament: A Long-Term Follow-Up

Overview
Journal Orthop Surg
Specialty Orthopedics
Date 2024 Nov 23
PMID 39579009
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Anterior controllable antedisplacement and fusion (ACAF) is an emerging surgical approach for treating cervical ossification of the posterior longitudinal ligament (C-OPLL), yet there is limited data on its long-term efficacy and safety. The present study aimed to analyze the short- and long-term postoperative clinical and radiological outcomes and perioperative complications of ACAF for patients with C-OPLL.

Methods: This was a single-center, retrospective, cohort study, with the mean duration of follow-up of at least 24 months. A total of 111 patients with C-OPLL in our institution from June 2017 to June 2019 were assessed preoperatively and at 3 days, 3, 6, 12, and 24 months postoperatively. The primary outcome was the recovery of neurological function, measured with the Japanese Orthopedic Association (JOA) score. The secondary outcomes included pain, Cobb angle, spinal canal invasion rate, and surgery-related complications.

Results: The postoperative JOA score at each follow-up was significantly better than the preoperative JOA score, regardless of preoperative spinal canal invasion rate, K-line, and segment length. The visual analog scale (VAS) score also decreased dramatically 3 days after surgery and was maintained at a low level throughout the follow-up period. Improvements in Cobb angle and invasion rate were observed right after the operation and were maintained for 2 years thereafter.

Conclusions: ACAF could achieve satisfactory recovery of neurological function in C-OPLL patients during a follow-up of 24 months, regardless of preoperative spinal canal invasion rate, preoperative K-line, or surgical segment length.

References
1.
Lei T, Shen Y, Wang L, Cao J, Ding W, Ma Q . Cerebrospinal fluid leakage during anterior approach cervical spine surgery for severe ossification of the posterior longitudinal ligament: prevention and treatment. Orthop Surg. 2012; 4(4):247-52. PMC: 6583446. DOI: 10.1111/os.12007. View

2.
Yang H, Sun J, Shi J, Guo Y, Zheng B, Wang Y . Anterior controllable antedisplacement fusion as a choice for 28 patients of cervical ossification of the posterior longitudinal ligament with dura ossification: the risk of cerebrospinal fluid leakage compared with anterior cervical corpectomy and.... Eur Spine J. 2018; 28(2):370-379. DOI: 10.1007/s00586-018-5813-8. View

3.
Sun J, Shi J, Xu X, Yang Y, Wang Y, Kong Q . Anterior controllable antidisplacement and fusion surgery for the treatment of multilevel severe ossification of the posterior longitudinal ligament with myelopathy: preliminary clinical results of a novel technique. Eur Spine J. 2017; 27(6):1469-1478. DOI: 10.1007/s00586-017-5437-4. View

4.
Fujimori T, Iwasaki M, Okuda S, Takenaka S, Kashii M, Kaito T . Long-term results of cervical myelopathy due to ossification of the posterior longitudinal ligament with an occupying ratio of 60% or more. Spine (Phila Pa 1976). 2013; 39(1):58-67. DOI: 10.1097/BRS.0000000000000054. View

5.
Miyazaki M, Ishihara T, Kanezaki S, Hirakawa M, Iwasaki T, Abe T . Relationship between K-line distance and surgical outcome in cases of laminoplasty for cervical ossification of the posterior longitudinal ligament. Medicine (Baltimore). 2022; 101(47):e31605. PMC: 9704886. DOI: 10.1097/MD.0000000000031605. View