Nature history and surgical intervention influence of cervical ossification of posterior longitudinal ligament / 中华骨科杂志

ABSTRACT

Cervical ossification of posterior longitudinal ligament (OPLL) is common in peopleover 50 years old.It can lead to compression myelopathy,which may end in paralysis when it's severe enough.It has quite a high prevalence in Asian,especially in Japan-cohort,while lower in other districts or races relatively.There have been many surgical methods aiming at cervical OPLL and all of them show satisfied short-term efficacy.However,there hasn't been a comprehensive discussion about disease evolution in natural circumstances as Well as its long-term prognosis up till now,which means that clinicians haven't got direct understanding.In that case it does make sense to ensure patients' natural progression and long-term post-surgical prognosis,from which summarized their rules in different cases with cervical OPLL.It is possible to analyze the long-term prognosis and provide suggestions to clinicians,with collection of papers about cervical OPLL's progression after conservative or surgical treatment and summing up cervical OPLL's radiological and clinical course either in natural circumstance or after surgical intervention.According to the review,ossified sites' axial length grows about 2 mm per year,while its thickness grows 0.2 mm per year.Young age and ossified sites of continuous/mixed types are its risk factors.Compared with natural course,laminectomy with fusion and all kinds of anterior approaches can inhibit ossification site's progression,while laminectomy and laminoplasty will speed it up.Young age and continuous/mixed type still contribute to the post-surgical progress of ossification sites.Symptoms of spinal cord are partly determined by the worsen of ossified site,which in the meantime is related to rate of occupation,range of motion,age and trauma history.Current surgical approaches are all able to eliminate symptoms,though anterior approaches undertake more intraoperative complications as well as better long-term prognosis than posterior ones.