Circumferential surgery for the management of cervical ossification of the posterior longitudinal ligament.
Can simultaneous anterior and posterior (circumferential) surgery in patients with cervical ossification of the posterior longitudinal ligament (OPLL)/stenosis, achieving both decompression and stabilization, be accomplished with acceptable risk? Between 1989 and 1996, 22 circumferential procedures were performed, including an average 2.5-level anterior corpectomy with 5-level posterior wiring and fusion. These patients were severely myelopathic (average Nurick grade 3.5) and were followed for a mean interval of 22 months (range 4-52 months). Circumferential procedures required an average of 9.8 h and 3.5 U of blood transfused. Postoperatively, patients improved approximately +3.0 Nurick grades. Simultaneous circumferential surgery for OPLL/stenosis may be successfully performed in <10 h with limited blood loss.
Epstein
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North Shore University Hospital, Manhasset, New York, USA.
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D012086:Reoperation; D013123:Spinal Fusion / Q000379:methods*; D013130:Spinal Stenosis / Q000209:etiology / Q000601:surgery*; D013924:Thrombophlebitis / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome