[Anterior multilevel corpectomy for the treatment of severe ossification of posterior longitudinal ligament in the cervical spine].

ABSTRACT

OBJECTIVE: To discuss the surgical indications, outcomes and complications of anterior multilevel corpectomy for the treatment of severe ossification of posterior longitudinal ligament (OPLL) in the cervical spine. METHODS: Between April 2006 and March 2008, a total of 25 patients (20 males and 5 females, age range 42 - 75 yr, mean 53. 2 yr) underwent anterior multilevel corpectomy for severe ossification of posterior longitudinal ligament in the cervical spine. Radiological studies showed that the type of OPLL was distributed as follows 7 local, 5 segmental, 8 continuous and 5 mixed. The OPLL extended an average of 2. 8 vertebrae (2 - 4) and the stenotic rate of spinal canal was 68.4% (50% - 97%). After corpectomy and removal of OPLL, titanium mesh cage and anterior plate were employed to restore cervical stability in all patients. RESULTS: Among these patients, 16 underwent two-level corpectomy and 9 three-level corpectomy. After a follow-up of 2 - 18 months, the mean JOA score increased from 9. 3 (5 - 12) points pre-operation to 14.2 (11 - 16) points post-operation. The mean improvement rate of neurological status was 63.2% (22.2% - 87.5%). The complications included CSF leakage in 6 cases (intermittent CSF pseudocyst in 4), nerve root palsy in 2, hematoma in 1 and transient neurological deterioration in 1. CONCLUSION: Anterior multilevel corpextomy can achieve a better clinical outcome in the treatment of severe cervical ossification of posterior longitudinal ligament. But it is technically demanding and carries a higher risk.