Surgical management of cervical cord injury with ossification of the cervical posterior longitudinal ligament.
OBJECTIVE
To identify an appropriate surgical approach for the management of cervical cord injury with ossification of the posterior longitudinal ligament.


METHODS
A retrospective study of 25 cases of cervical cord injury with ossification of the posterior longitudinal ligament was performed. Two cases were classified as Frankel grade A, three as grade B, fourteen as grade C, and six as grade D. Treatment procedures consisted of anterior decompression with instrumentation (twelve patients), posterior decompression (eight patients), and combined anterior and posterior decompression (five patients).


RESULTS
There were no iatrogenic injuries of great vessels, trachea, esophagus or spinal cord. All patients were followed up for 15-86 months (average, 38.3 months). All segment with anterior fixation attained solid fusion, without implants loosening or breakage. No reclosed open-door was found after posterior laminoplasty. Twenty-one patients improved by one to two Frankel grades. The patients with complete spinal cord injury achieved no neurologic recovery, but did experience relief of upper limb pain or numbness.


CONCLUSIONS
The surgical outcomes of cervical cord injury with ossification of the posterior longitudinal ligament were satisfactory. It is important to select a suitable surgical approach according to the findings on radiological imaging and the clinical characteristics and general condition of the patients.
Department of Spinal Surgery, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China. doctoryangdalong@163.com
Da-long
DL
Yang
Ying-ze
YZ
Zhang
Yong
Y
Shen
Jun-ming
JM
Cao
D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; 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*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome