Surgical strategy for ossification of the posterior longitudinal ligament in the cervical spine.

@article{Chen2012SurgicalSF,
  title={Surgical strategy for ossification of the posterior longitudinal ligament in the cervical spine.},
  author={Yu Chen and Xiaowei Liu and De-yu Chen and Xinwei Wang and Wen Yuan},
  journal={Orthopedics},
  year={2012},
  volume={35 8},
  pages={
          e1231-7
        }
}
Ossification of the posterior longitudinal ligament is a common cause of cervical myelopathy, and controversy remains regarding surgical options. Between January 2004 and December 2007, a total of 164 patients with ossification of the posterior longitudinal ligament in the cervical spine who underwent surgical treatment at the authors' institution were included in this study. The choice of surgical option was based on pathological extent and cervical alignment. Short-segment pathology was… 
Surgical outcome in patients with cervical ossified posterior longitudinal ligament: A single institutional experience
TLDR
Anterior cervical decompression and reconstruction is a safe and appropriate treatment for cervical spondylitic myelopathy in the setting of single or two level OPLL.
Anterior Cervical Corpectomy and Fusion Versus Posterior Laminoplasty for Cervical Oppressive Myelopathy Secondary to Ossification of the Posterior Longitudinal Ligament: A Meta-analysis.
TLDR
The authors recommend anterior cervical corpectomy with fusion for cervical ossification of the posterior longitudinal ligament when the canal occupying ratio is 50% or greater, and they prefer laminoplasty when the Canal Occupation ratio is less than 50%.
Comparison of the surgeries for the ossification of the posterior longitudinal ligament-related cervical spondylosis
TLDR
It is found that ACCF achieved the most improvement in the Japanese Orthopaedic Association Scores and excellent and good recovery rate, ACAF achieved the best improvement of the improvement rate and lordosis, and LP got the best operative time and blood loss.
Comparison of laminoplasty versus laminectomy and fusion in the treatment of multilevel cervical ossification of the posterior longitudinal ligament
TLDR
Both LP and LF can achieve clinical improvement in the treatment of multilevel cervical OPLL and Kyphosis line (K-line) may be a good criterion in the selection of posterior surgery.
Anterior controllable antidisplacement and fusion surgery for the treatment of multilevel severe ossification of the posterior longitudinal ligament with myelopathy: preliminary clinical results of a novel technique
TLDR
Though further study is required to confirm the conclusion, this novel technique has the potential to serve as an alternative surgical technique for the treatment of cervical OPLL and demonstrates that excellent postoperative outcome can be achieved with the use of the ACAF.
The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis
TLDR
Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level, suggesting Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL.
Anterior cervical corpectomy and fusion versus posterior laminoplasty for the treatment of oppressive myelopathy owing to cervical ossification of posterior longitudinal ligament: a meta-analysis
TLDR
Comparing the clinical efficacy, postoperative complication and surgical trauma between anterior cervical corpectomy and fusion versus posterior laminoplasty for the treatment of oppressive myelopathy owing to cervical ossification of the posterior longitudinal ligament revealed no obvious statistical difference in preoperative JOA score between the ACCF and LAMP groups in both subgroups.
Anterior corpectomy versus posterior laminoplasty for multilevel cervical myelopathy: a systematic review and meta-analysis
TLDR
A systematic review and meta-analysis of cohort studies comparing anterior CORP with posterior LAMP for the treatment of multilevel cervical myelopathy from 1990 to December 2012 indicated that the mean JOA score system for cervicalMyelopathy and the neurological RR in the CORP group were superior to those in the LAMP group when the mean surgical segments were <3, but were similar between the two groups.
Comparison of clinical outcomes in decompression and fusion versus decompression only in patients with ossification of the posterior longitudinal ligament: a meta-analysis.
OBJECTIVE Ossification of the posterior longitudinal ligament (OPLL) is a pathological calcification or ossification of the PLL, predominantly occurring in the cervical spine. Although surgery is
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References

SHOWING 1-10 OF 21 REFERENCES
Surgical Strategy for Cervical Myelopathy due to Ossification of the Posterior Longitudinal Ligament: Part 2: Advantages of Anterior Decompression and Fusion Over Laminoplasty
TLDR
ADF yielded a better neurologic outcome at final follow-up than laminoplasty in patients with occupying ratio ≥60%, although graft complications occurred in 15% and additional surgical intervention was required in 26%.
Morphologic limitations of posterior decompression by midsagittal splitting method for myelopathy caused by ossification of the posterior longitudinal ligament in the cervical spine.
TLDR
Patients who exhibit significant risk factors for continued contact of the spinal cord should be morphologically considered for anterior decompression for ossification of the posterior longitudinal ligament.
Multisegmental cervical ossification of the posterior longitudinal ligament: anterior vs posterior approach.
TLDR
From the analysis, it appears that the posterior approach is probably the preferred method of treatment in a multisegmental cervical OPLL in absence of preoperative kyphosis.
Ossified posterior longitudinal ligament: management strategies and outcomes.
  • J. Mizuno, H. Nakagawa
  • Medicine
    The spine journal : official journal of the North American Spine Society
  • 2006
Diagnosis and surgery of ossification of posterior longitudinal ligament associated with dural ossification in the cervical spine
TLDR
ACF is meritorious for the patient with OPLL associated with DO, although more difficult manipulation and higher risk of CSF leakage.
Relative Safety of Anterior Microsurgical Decompression Versus Laminoplasty for Cervical Myelopathy With a Massive Ossified Posterior Longitudinal Ligament
TLDR
Anterior microsurgical decompression for a massive ossified posterior longitudinal ligament, although technically more demanding, seems counterintuitively safer than laminoplasty.
An Analysis of Factors Causing Poor Surgical Outcome in Patients With Cervical Myelopathy Due to Ossification of the Posterior Longitudinal Ligament: Anterior Decompression With Spinal Fusion Versus Laminoplasty
TLDR
It is recommended that ASF should be the first choice of treatment for patients with significant ossification of the posterior longitudinal ligament and a hypermobile cervical spine and the addition of posterior instrumented fusion would be desirable for stabilizing the spine and decreasing damage to the spinal cord.
Five-year Follow-up Evaluation of Surgical Treatment for Cervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: A Prospective Comparative Study of Anterior Decompression and Fusion With Floating Method Versus Laminoplasty
TLDR
ADF is considered especially suitable for cases with massive OPLL and preoperative kyphotic alignment of the cervical spine, although it leads to a higher incidence of surgery-related complications compared with LAMP.
C5 Palsy After Laminectomy and Posterior Cervical Fixation for Ossification of Posterior Longitudinal Ligament
TLDR
The tethering effect on the root seemed to be the main pathogenic mechanism of C5 root palsies in this study, and there was no significant positive correlation with an increase in T2-weighted hyperintense foci on magnetic resonance studies.
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