Surgical Management of Cervical Ossification of Posterior Longitudinal Ligament: The Treatment Algorithm and Outcome

Abstract

IntroductionManaging patients who present with symptoms of cervical myelopathy secondary to cervical ossification of the posterior longitudinal ligament (OPLL) is challenging. Various factors such as the number of levels involved with OPLL, types of OPLL, canal occupying ratio, K-line characteristics, and C2-C7 lordosis angle were found to guide decision-making and surgical approaches in managing this condition. However, no clear treatment algorithm has been published. This study aims to investigate the outcome of the management of cervical OPLL using a treatment algorithm used in a tertiary university hospital. MethodsThis is a retrospective cross-sectional study. Patients with cervical myelopathy secondary to cervical OPLL who were treated surgically in our center from 2014 to 2020 were included in this study. Demographic data and preoperative parameters that determined the treatment given according to our treatment algorithm were analyzed. ResultA total of 24 patients fit the inclusion and exclusion criteria of the study. The mean recovery rate for all groups is 61.8 21.9% and the mean postoperative neck disability index (NDI) is 17.83 16.67%. There was a statistically significant difference between preoperative and postoperative Japanese Orthopaedic Association (JOA) scores for both anterior and posterior surgery subgroups. ConclusionWe believe that the treatment algorithm used in our center could benefit other surgeons as a guide in managing patients who suffer from cervical myelopathy secondary to cervical OPLL. Further study including newer techniques would increase the surgeon's arsenal in providing the best outcome in managing this condition.

The clinical efficacy of laminectomy fusion fixation and posterior single open-door laminoplasty in the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL): a retrospective study

“…So some scholars believe that anterior surgery is the most effective and ideal approach, especially anterior cervical corpectomy, decompression, and fusion (ACCF) [ 8 ]. However, some authors have reported that both anterior and posterior approaches can lead to significant improvements in clinical outcomes [ 9 ]. Posterior surgeries like laminectomy and laminoplasty are commonly used to treat multiple-level cervical OPLL.…”