Surgical Treatment for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine

Abstract

The results of surgical management of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine consisting of either anterior or posterior surgical decompression of the spinal cord and/or nerve roots were evaluated in 75 patients. The OPLL was continuous (COPLL) in 37 patients, segmental (SOPLL) in 29, mixed COPLL and SOPLL (MOPLL) in five, and circumscribed disk type (DOPLL) in four. Fourteen of the patients with COPLL, 27 with SOPLL, three with MOPLL, and all four with DOPLL were treated via the anterior approach with vertebrectomy and discectomy with anterior fusion. The remaining patients were treated by posterior laminoplasty or laminectomy. The overall mean improvement in the neurosurgical cervical spine scale (NCSS) score after surgery was 78.0% in those treated with anterior decompression and 46.1% in those treated with posterior decompression. The NCSS score in the latter group decreased during the follow-up period, from 10.4 to 9.7 points, whereas that in the anterior decompression group increased, from 12.9 to 13.0.