Anterior decompression for ossification of the posterior longitudinal ligament of the cervical spine

Abstract

Anterior decompression and fusion for treating ossification of the posterior longitudinal ligament of the cervical spine was performed in 12 patients. The central part of the vertebral body and the ossified area of the posterior longitudinal ligament were removed by means of a microrongeur and an air drill. The defect was filled with a long bone graft taken from the ilium. The operative results were excellent. Marked improvement of radicular and spinal cord signs was seen in all 12 cases. Three vertebral bodies were fused in one case, four in nine cases, and five in two cases. The highest level of fusion was C-2 and the lowest was T-1. It is considered that any ossification of the ligament below the C-2 level can be removed via an anterior approach as long as no more than five vertebral bodies are involved. Spinal computerized tomography was valuable in providing more detailed information about the stenotic spinal canal and the shape of the ossified ligament.

Dorsal versus ventral surgery for cervical ossification of the posterior longitudinal ligament: considerations for approach selection and review of surgical outcomes

“…1,30,31 There has been considerable debate in recent years regarding the optimal surgical approach for addressing these compressive lesions. Ventral approaches consist of variations of the cervical corpectomy, whereas dorsal approaches include a wide range of techniques including laminoplasty, laminectomy, and laminectomy with instrumented fusion.…”

Laminoplasty outcomes: is there a difference between patients with degenerative stenosis and those with ossification of the posterior longitudinal ligament?

“…5,13,23,34 Although it is more intuitive to decompress the spinal cord anteriorly, at the origin of the OPLL mass effect, complications like CSF leaks are not uncommon. 1,2,7,14,36 Posterior approaches allow for expansion of the spinal canal and indirect decompression of multiple segments. Therefore, surgical treatment should be tailored according to each patient's condition and each surgeon's level of confidence with a particular technique.…”

New Instrument for Creating Bone Graft Cavities for Anterior Cervical Decompression and Fusion: the Anterior Fusion Spinal Fork

“…Transverse resection of 14-15 mm has been recommended. 1) Intraoperative computed tomography has been used to assess the adequacy of decompression in anterior cervical spine surgery, 6) whereas intraoperative three-dimensional fluoroscopy was used to evaluate sufficient bone decompression. 4) However, such modalities are relatively costly and may be available in only a limited number of hospitals around the world.…”