[Anterior multilevel corpectomy for the treatment of severe ossification of posterior longitudinal ligament in the cervical spine].
OBJECTIVE
To discuss the surgical indications, outcomes and complications of anterior multilevel corpectomy for the treatment of severe ossification of posterior longitudinal ligament (OPLL) in the cervical spine.


METHODS
Between April 2006 and March 2008, a total of 25 patients (20 males and 5 females, age range: 42 - 75 yr, mean: 53. 2 yr) underwent anterior multilevel corpectomy for severe ossification of posterior longitudinal ligament in the cervical spine. Radiological studies showed that the type of OPLL was distributed as follows: 7 local, 5 segmental, 8 continuous and 5 mixed. The OPLL extended an average of 2. 8 vertebrae (2 - 4) and the stenotic rate of spinal canal was 68.4% (50% - 97%). After corpectomy and removal of OPLL, titanium mesh cage and anterior plate were employed to restore cervical stability in all patients.


RESULTS
Among these patients, 16 underwent two-level corpectomy and 9 three-level corpectomy. After a follow-up of 2 - 18 months, the mean JOA score increased from 9. 3 (5 - 12) points pre-operation to 14.2 (11 - 16) points post-operation. The mean improvement rate of neurological status was 63.2% (22.2% - 87.5%). The complications included CSF leakage in 6 cases (intermittent CSF pseudocyst in 4), nerve root palsy in 2, hematoma in 1 and transient neurological deterioration in 1.


CONCLUSIONS
Anterior multilevel corpextomy can achieve a better clinical outcome in the treatment of severe cervical ossification of posterior longitudinal ligament. But it is technically demanding and carries a higher risk.
Chen
De-Yu
DY
Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. chenspine@yahoo.com
Chen
Yu
Y
Lu
Xu-Hua
XH
Yan
Wang-Jun
WJ
Wang
Xin-Wei
XW
Song
Dian-Wen
DW
Yuan
Wen
W
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology; D019299:Decompression, Surgical; D017586:Diskectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome