title: Anterior corpectomy with fusion in combination with an anterior cervical plate in the management of ossification of the posterior longitudinal ligament.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the safety and efficacy of an anterior cervical plate (ACP) used in combination with anterior corpectomy with fusion (ACF) for cervical ossification of the posterior longitudinal ligament (OPLL).
  
  
  BACKGROUND
  Consensus is lacking about the most suitable method to treat cervical myelopathy caused by OPLL. The decision to perform an ACF to treat multilevel myelopathy is controversial because of the potential for problems in the grafted bone.
  
  
  METHODS
  We evaluated the surgical outcome of ACF combined with insertion of an ACP for treating cervical myelopathy caused by OPLL. The study group comprised 68 patients who were treated from 2006 to 2009 and followed for an average of 29.6 months. We retrospectively reviewed the information in the patients' charts and radiographs.
  
  
  RESULTS
  No dislodgement of the grafted bone or implant was observed, and no patient developed infection, esophageal or tracheal lacerations, or rupture. Radiographs showed no evidence of nonunion. The mean preoperative and the final follow-up C2 to C7 lordotic angles were 6.2±9.5 degrees and 9.4±7.6 degrees, respectively. The preoperative and the final follow-up lordotic angles of the fusion area were 2.0±8.1 degrees and 5.9±6.4 degrees, respectively. The average change in fusion area length was a 1.2 mm increase from before to after the operation and a 1.8 mm decrease from after the operation to the final follow-up. The average recovery rate of the Japanese Orthopaedic Association score was 63.0%. The surgical outcome of ACF with an ACP is satisfactory.
  
  
  CONCLUSIONS
  Insertion of an ACP is a good solution for preventing problems with the grafted bone after ACF. Our study suggests that the indications for an anterior-only procedure for the management of cervical OPLL can be expanded.
authors: Department of Orthopaedic Surgery, Gakkentoshi Hospital, 7-4-1 Seikadai, Seikacho, Sorakugun, Kyoto, Japan. s-odate@iseikai.jp
authors: Seiichi
authors: S
authors: Odate
authors: Jitsuhiko
authors: J
authors: Shikata
authors: Hiroaki
authors: H
authors: Kimura
authors: Satoru
authors: S
authors: Yamamura
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000175:diagnosis* / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome