Treatment of cervical OPLL by cervical anterior fusion using autologous vertebral bone grafts.
BACKGROUND
In anterior fusion, we use autologous bone grafts from cervical vertebral bodies and bioabsorptive screws to prevent graft extrusion (Williams-Isu method). We report the application of and indication for the Williams-Isu method for OPLL and present our clinical and radiological results.


METHODS
Using the Williams-Isu method, we treated 17 patients with cervical OPLL; 15 had segmental- and 2 had continuous-type OPLL. The median follow-up term was 24 months. The patients underwent anterior decompression and fusion at a single level (n = 8) or at two levels (n = 9). As a control, 17 patients with cervical spondylosis underwent anterior single-level decompression and fusion using the Williams-Isu method. Pre- and postoperative radiographs of the cervical spine were obtained in all patients, and the alignment of the whole cervical and fused segment and the height of the fused segment were compared.


RESULTS
All but one patient experienced alleviation of clinical symptoms without deterioration during the follow-up period. The recovery rate on the JOA score was 71.7%. The patient with continuous-type OPLL suffered postoperative neurological deterioration because of a remnant of the upper-level OPLL. Radiological studies confirmed the absence of bone graft dislocation and fracture, and of satisfactory bone fusion in all patients. There was no significant difference between the two patient groups with respect to whole spine alignment and the alignment and height of the fused segment.


CONCLUSIONS
The Williams-Isu method is useful for treating not only cervical spondylosis but also cervical segmental OPLL at one or two levels.
Kim
Kyongsong
K
Department of Neurosurgery, Chiba Hokusoh Hospital, Nippon Medical School, Inba-gun, Chiba 270-1694, Japan. kyongson@nms.ac.jp
Isu
Toyohiko
T
Sugawara
Atsushi
A
Morimoto
Daijiro
D
Matsumoto
Ryoji
R
Isobe
Masanori
M
Mishina
Masahiro
M
Kobayashi
Shiro
S
Teramoto
Akira
A
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D016268:Internal Fixators; D017846:Longitudinal Ligaments / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
D001672:Biocompatible Materials