A Novel Anterior Revision Surgery for the Treatment of Cervical Ossification of Posterior Longitudinal Ligament: Case Report and Review of the Literature.

Abstract

A 62-year-old blind man with severe ossification of the posterior longitudinal ligament was presented. The patient underwent posterior laminectomy and fixation. After surgery, the patient was not satisfied with the recovery of his upper limbs although his Japanese Orthopedic Association (JOA) score had increased from 9 to 12 points. Because the tactile sensation of his hands was especially important to his daily life, the patient asked for further treatment after 6 months. This report describes the novel revision surgery we invented and the outcome in the patient after the surgery. We performed the revision surgery using an anterior approach from C3 to C7 with a novel technique, anterior controllable antedisplacement and fusion (ACAF). The patient was followed up for 6 months. The clinical data, including JOA score and radiologic images, were collected and analyzed. After the revision surgery, the patient had improved sensation in both hands, and his JOA score increased to 14 points. Satisfactory decompression was assessed by magnetic resonance imaging after operation. Bone fusion was confirmed by computed tomography 3 months after operation. No specific complications related to this surgery were observed. The application of such an operative procedure in revision surgery for OPLL has not been reported earlier and might be an alternative choice for patients with an unsatisfactory outcome from previous posterior surgery.