J Korean Neurosurg Soc.  2010 Oct;48(4):335-341.

Single Stage Circumferential Cervical Surgery (Selective Anterior Cervical Corpectomy with Fusion and Laminoplasty) for Multilevel Ossification of the Posterior Longitudinal Ligament with Spinal Cord Ischemia on MRI

• Son S
• Lee SG
• Yoo CJ
• Park CW
• Kim WK

Abstract

OBJECTIVE
Anterior cervical corpectomy with fusion (ACF) or laminoplasty may be associated with substantial number of complications for treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL) with significant cord compression. For more safe decompression and stabilization in multilevel cervical OPLL with prominent cord compression, we propose circumferential cervical surgery (selective ACF and laminoplasty) based on our favorable experience.
METHODS
Twelve patients with cervical myelopathy underwent circumferential cervical surgery and all patients showed multilevel OPLL with signal change of the spinal cord on magnetic resonance imaging (MRI). A retrospective review of clinical, radiological, and surgical data was conducted.
RESULTS
There were 9 men and 3 women with mean age of 56.7 years and a mean follow up period of 15.6 months. The average corpectomy level was 1.16 and laminoplasty level was 4.58. The average Japanese Orthopedic Association score for recovery was 5.1 points and good clinical results were obtained in 11 patients (92%) (p < 0.05). The average space available for the cord improved from 58.2% to 87.9% and the average Cobb's angle changed from 7.63 to 12.27 at 6 months after operation without failure of fusion (p < 0.05). Average operation time was 8.36 hours, with an estimated blood loss of 760 mL and duration of bed rest of 2.0 days. There were no incidences of significant surgical complications, including wound infection.
CONCLUSION
Although the current study examined a small sample with relatively short-term follow-up periods, our study results demonstrate that circumferential cervical surgery is considered favorable for safety and effectiveness in multilevel OPLL with prominent cord compression.

Keyword

Ossification of the posterior longitudinal ligament; Anterior cervical corpectomy with fusion; Laminoplasty; Japanese Orthopedic Association score

MeSH Terms

Asian Continental Ancestry Group
Bed Rest
Decompression
Female
Follow-Up Studies
Humans
Incidence
Longitudinal Ligaments
Magnetic Resonance Imaging
Male
Orthopedics
Retrospective Studies
Spinal Cord
Spinal Cord Diseases
Spinal Cord Ischemia
Wound Infection