[Anterior decompression for the treatment of cervical spondylotic myelopathy associated with ossification of posterior longitudinal ligament].
OBJECTIVE
To study the technique and effect of anterior decompression for the treatment of cervical spondylotic myelopathy associated with ossification of posterior longitudinal ligament (OPLL).


METHODS
Sixty-one patients (42 male and 19 female, 45 - 74 years with mean age of 57 years old) underwent anterior decompression for the treatment of cervical spondylotic myelopathy associated with OPLL. Among them, OPLL was definitely diagnosed in 49 patients preoperatively, and was found during the operation in the other 12 patients. The occupying rate of OPLL ranged 32%-70% with an average of 52%. The preoperative JOA scores ranged 4 - 14 points with an average of 9.6 points. In additional to conventional decompression, the ossification was removed completely after discectomy and corpectomy.


RESULTS
Corpectomy was performed in 41 cases, discectomy in 6 cases and combination of corpectomy and discectomy in 14 cases. The follow-up of all patients ranged from 6 to 36 months (mean 16 months). The postoperative JOA scores ranged 8-16 points with an average of 12.8 points. The neurological improvement rate ranged from 25.0% to 87.5% with an average of 65.2%. The transient leakage of cerebrospinal fluid (CSF) occurred in 5 cases, and stopped after conservational treatment. No neurological deterioration developed.


CONCLUSIONS
The difficulty and risk of anterior decompression are significantly increased in the patients with cervical spondylotic myelopathy associated with OPLL. Remove of ossification after corpectomy and discectomy could provide complete decompression and better results.
Chen
De-yu
DY
Department of Orthopaedic Surgery, Changzheng Hospital, Shanghai 200003, China. chenspine@yahoo.com
Lu
Xu-hua
XH
Chen
Yu
Y
Yan
Wang-jun
WJ
Yang
Hai-song
HS
Wang
Xin-wei
XW
Huang
Ping
P
Yuan
Wen
W
D000368:Aged; D002574:Cervical Vertebrae; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000601:surgery*; D013128:Spinal Osteophytosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome