Risk Factors and Management of Dural Defects in Anterior Surgery for Cervical Ossification of the Posterior Longitudinal Ligament

Du, Yue-Qi; Duan, Wanru; Chen, Zan; Wu, Hao; Jian, Fengzeng

doi:10.1016/j.wneu.2017.12.113

Cited by 13 publications

(5 citation statements)

References 41 publications

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“…Later, he replicated this finding with a multi-center study 10) and suggested that dynamic factors may be largely involved in inducing myelopathy. However, recent papers have failed to reproduce this finding 2,4) . This may be due to the small cohorts and the inherent nature of the data source.…”

Section: Discussionmentioning

confidence: 99%

A New Classification for Cervical Ossification of the Posterior Longitudinal Ligament Based on the Coexistence of Segmental Disc Degeneration

Lee

Ham

Kwon

et al. 2021

J Korean Neurosurg Soc

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Objective : Classification systems for cervical ossification of the posterior longitudinal ligament (OPLL) have traditionally focused on the morphological characteristics of ossification. Although the classification describes many clinical features associated with the shape of the ossification, including the concept of spondylosis seems necessary because of the similarity in age distribution. Methods : Patients diagnosed with OPLL who presented with increase signal intensity (ISI) on magnetic resonance imaging were surgically treated in our department. The patients were divided into two groups (pure versus degenerative) according to the presence of disc degeneration. Results : Of 141 patients enrolled in this study, more than half (61%) were classified into the degenerative group. The pure group showed a profound male predominance, early presentation of myelopathy, and a different predilection for ISI compared to the degenerative group. The mean canal compromise ratio (CC) of the ISI was 47% in the degenerative group versus 61% in the pure group (p<0.0000). On the contrary, the global and segment motions were significantly larger in the degenerative group (p<0.0000 and p=0.003, respectively). The canal diameters and global angles did not differ between groups. Conclusion : Classifying cervical OPLL based on the presence of combined disc degeneration is beneficial for understanding the disorder's behavior. CC appears to be the main factor in the development of myelopathy in the pure group, whereas additional dynamic factors appear to affect its development in the degenerative group.

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Section: Discussionmentioning

confidence: 99%

A New Classification for Cervical Ossification of the Posterior Longitudinal Ligament Based on the Coexistence of Segmental Disc Degeneration

Lee

Ham

Kwon

et al. 2021

J Korean Neurosurg Soc

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“…The wider the OPLL base was, the more likely was postoperative CSFL occurrence (OR =1.3, P=0.007). Du et al (16) came to a similar conclusion in studying the risk factors of CSFL after use of anterior approach cervical OPLL decompression. Du et al collected the data of 90 patients who underwent anterior approach cervical decompression to treat cervical OPLL and found that CSFL is more likely to happen during resection of a widebased OPLL (OR =1.09; P=0.012) than that of a narrowbased OPLL.…”

Section: Discussionmentioning

confidence: 63%

Predicting cerebrospinal fluid leakage prior to posterior circumferential decompression for the ossification of the posterior longitudinal ligament in the thoracic spine

2021

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“…A reported incidence of CSF fistulas was 5.1%-25% during cervical surgery for OPLL. [38][39][40] This meta-analysis displayed that iatrogenic dura tear and CSF leakage was 3.74% in the ADF group. Dura tear was closely related with adhesion to OPLL, the incidence might be underestimated.…”

Section: Discussionmentioning

confidence: 90%

The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis

Kim

Lee

et al. 2019

Neurospine

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Objective: Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods: We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results: We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion: Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL.

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Risk Factors and Management of Dural Defects in Anterior Surgery for Cervical Ossification of the Posterior Longitudinal Ligament

Cited by 13 publications

References 41 publications

A New Classification for Cervical Ossification of the Posterior Longitudinal Ligament Based on the Coexistence of Segmental Disc Degeneration

A New Classification for Cervical Ossification of the Posterior Longitudinal Ligament Based on the Coexistence of Segmental Disc Degeneration

Predicting cerebrospinal fluid leakage prior to posterior circumferential decompression for the ossification of the posterior longitudinal ligament in the thoracic spine

The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis

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