title: Circumferential surgery for the management of cervical ossification of the posterior longitudinal ligament.
abstract: 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.
authors.affiliation: North Shore University Hospital, Manhasset, New York, USA.
authors.forename: N E
authors.initials: NE
authors.lastname: Epstein
mesh_terms: 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