A systematic review of complications in cervical spine surgery for ossification of the posterior longitudinal ligament.
BACKGROUND
Surgical management of ossification of the posterior longitudinal ligament (OPLL) is associated with complications. However, surgical complications for OPLL have not been clearly documented.


OBJECTIVE
To review and summarize the incidence of surgical complications of OPLL in the cervical spine and evaluate the impact of surgical approach (anterior or posterior), year of study publication, follow-up duration, and the surgical outcome on complication incidence.


METHODS
Systematic review.


METHODS
An English literature review was conducted especially on surgical complications of cervical OPLL. The incidence of complications was statistically summarized, with its correlation to surgical approaches, year of study publications, follow-up duration, and the surgical outcome was statistically evaluated.


RESULTS
Twenty-seven retrospective studies, including a total of 1,558 patients, were reviewed. The overall incidence of surgical complications of cervical OPLL was 21.8%. Neurologic deficit (8.3%, overall rate), cerebrospinal fluid leakage (CFL) (5.1%), axial pain (3.5%), and implant complications (3.5%) were relatively common. The incidence of complications for posterior approach was not statistically different from those for anterior procedures. However, with regard to individual complication, C5 palsy and axial pain occurred more frequently in patients approached posteriorly, whereas CFL, implant complications, hoarseness, dysphagia, and dyspnea appeared more common in anterior cases.


CONCLUSIONS
There is a relatively high incidence of surgical complications for cervical OPLL compared with other cervical degeneration diseases. It is, therefore, necessary for surgeons to take into consideration the risk of surgical complications when communicating with patients for decision making and to alert complications during or after surgical procedures.
Department of Orthopedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Rd, Shanghai 200092, China.
Hai
H
Li
Li-Yang
LY
Dai
D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D015994:Incidence; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D017887:Ossification of Posterior Longitudinal Ligament / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*