Long-term results of the anterior floating method for cervical myelopathy caused by ossification of the posterior longitudinal ligament.
METHODS
Results of the anterior floating method used to decompress ossification of the posterior longitudinal ligament were studied for an average postoperative interval of 13 years.


OBJECTIVE
To investigate the long-term results of the anterior floating method used to manage ossification of the posterior longitudinal ligament.


BACKGROUND
The anterior floating method is a technique that differs from the extirpation method used to manage ossification of the posterior longitudinal ligament. Reports of the long-term results from anterior decompression used to manage cervical ossification of the posterior longitudinal ligament are rare.


METHODS
The anterior floating method was used to decompress cervical ossification of the posterior longitudinal ligament in 63 patients. These patients were followed for more than 10 years with neurologic evaluations using a scoring system proposed by the Japanese Orthopedic Association (JOA score).


RESULTS
The recovery rate was 66.5% at 10 years and 59.3% at 13 years, the time of the final survey. Operative outcomes most closely reflected the preoperative duration and severity of myelopathy (JOA score) and the preoperative cross-sectional area of the spinal cord. There was no correlation with the canal narrowing ratio or the thickness of ossification of the posterior longitudinal ligament. Delayed deterioration was attributed to an original inadequate decompression and progression of ossification of the posterior longitudinal ligament outside the original operative field. There was no evidence of significant recurrent ossification of the posterior longitudinal ligament within the margins of prior decompression.


CONCLUSIONS
The anterior floating method appears to yield adequate long-term outcomes when used to manage ossification of the posterior longitudinal ligament.
Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan. matsuokat@aol.com
T
T
Matsuoka
I
I
Yamaura
Y
Y
Kurosa
O
O
Nakai
S
S
Shindo
K
K
Shinomiya
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D017846:Longitudinal Ligaments / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D011859:Radiography; D055502:Secondary Prevention; D013115:Spinal Canal / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome