Anterior decompression for the treatment of cervical spondylotic myelopathy associated with ossification of posterior longitudinal ligament / 中华外科杂志

<p><b>OBJECTIVE</b>To study the technique and effect of anterior decompression for the treatment of cervical spondylotic myelopathy associated with ossification of posterior longitudinal ligament (OPLL).</p><p><b>METHOD</b>Sixty-one patients (42 male and 19 female, 45 - 74 years with mean age of 57 years old) underwent anterior decompression for the treatment of cervical spondylotic myelopathy associated with OPLL. Among them, OPLL was definitely diagnosed in 49 patients preoperatively, and was found during the operation in the other 12 patients. The occupying rate of OPLL ranged 32%-70% with an average of 52%. The preoperative JOA scores ranged 4 - 14 points with an average of 9.6 points. In additional to conventional decompression, the ossification was removed completely after discectomy and corpectomy.</p><p><b>RESULTS</b>Corpectomy was performed in 41 cases, discectomy in 6 cases and combination of corpectomy and discectomy in 14 cases. The follow-up of all patients ranged from 6 to 36 months (mean 16 months). The postoperative JOA scores ranged 8-16 points with an average of 12.8 points. The neurological improvement rate ranged from 25.0% to 87.5% with an average of 65.2%. The transient leakage of cerebrospinal fluid (CSF) occurred in 5 cases, and stopped after conservational treatment. No neurological deterioration developed.</p><p><b>CONCLUSIONS</b>The difficulty and risk of anterior decompression are significantly increased in the patients with cervical spondylotic myelopathy associated with OPLL. Remove of ossification after corpectomy and discectomy could provide complete decompression and better results.</p>

Clinical characteristics and results of cervical spinal cord injury in the patients with ossification of the posterior longitudinal ligament / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and results of cervical spinal cord injury (SCI) in the patients with ossification of the posterior longitudinal ligament (OPLL).</p><p><b>METHODS</b>Nineteen patients with cervical SCI associated with OPLL were retrospectively analyzed. Data collection included: pre- and postoperative neurological function, OPLL-type, MRI signal changes and surgical approaches.</p><p><b>RESULTS</b>Spinal cord associated with OPLL was injured severely by mild trauma. Methylprednisolone sodium succinate was used within 8 h after trauma in 12 cases. Two of them died of complications. The neurological functions were markedly improved in the other 10 cases. Seventeen cases had surgical treatment. The neurological functions (Frankel grade) were improved significantly in the operated patients except for one, who died 27 d after operation.</p><p><b>CONCLUSIONS</b>The patients with OPLL are prone to have severe SCI, which directly associates with the preexisting OPLL-type and hyper-intensity signal change in the spinal cord on MRI. Both of using methylprednisolone sodium succinate administration within 8 h after trauma and surgical decompression may improve the neurological outcomes.</p>