The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments
PurposeCreating enough decompression, favorable outcome, less complication, and maintain adequate lordosis and stability in the patients with cervical myelopathy due to multilevel massive ossification of the posterior longitudinal ligament (OPLL) still poses a challenge for surgeons. The aim of our...
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| Format: | Article |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1066120/full |
| _version_ | 1797960387266609152 |
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| author | Ying-Ching Li Zhuo-Hao Liu Zhuo-Hao Liu Ying-Sheng Li Mun-Chun Yeap Yu-Tse Liu Yin-Cheng Huang Ching-Chang Chen Po-Hsun Tu Po-Hsun Tu |
| author_facet | Ying-Ching Li Zhuo-Hao Liu Zhuo-Hao Liu Ying-Sheng Li Mun-Chun Yeap Yu-Tse Liu Yin-Cheng Huang Ching-Chang Chen Po-Hsun Tu Po-Hsun Tu |
| author_sort | Ying-Ching Li |
| collection | DOAJ |
| description | PurposeCreating enough decompression, favorable outcome, less complication, and maintain adequate lordosis and stability in the patients with cervical myelopathy due to multilevel massive ossification of the posterior longitudinal ligament (OPLL) still poses a challenge for surgeons. The aim of our study is to retrospectively evaluate our patients and try to seek a better surgical strategy.MethodsBetween 2015 and 2019, 55 consecutive patients with multilevel massive OPLL underwent surgical treatment. Among these, 40 patients were treated with cervical laminectomy and then anterior decompression, fusion, and fixation (ADF), which was defined as group 1, and 15 patients were treated with cervical laminectomy and fixation simultaneously, which was defined as group 2. The patient's radiographic characteristics and postoperative outcomes were evaluated.ResultsBetter postoperative cervical sagittal lordosis and less long-term axial pain was achieved in group 1 (p < 0.001), though the functional outcome had no significant difference. In the multivariable analysis, anterior fixation accounts for independent factors for better cervical sagittal alignment (p < 0.001). No complications directly associated with cervical laminectomy were observed.ConclusionIn patients with cervical multilevel massive OPLL, laminectomy at compression level and then ADF depended on the severity and range of compression, but corpectomy of not more than two vertebral bodies is suggested, except K-line (+) and long-segment massive OPLL majorly involving the C2 and posterior laminectomy above and below the OPLL-affected levels with posterior fixation simultaneously. |
| first_indexed | 2024-04-11T00:45:13Z |
| format | Article |
| id | doaj.art-e7d207fdbe4244c6b3e8941af5384b77 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T00:45:13Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-e7d207fdbe4244c6b3e8941af5384b772023-01-05T18:57:56ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-12-01910.3389/fsurg.2022.10661201066120The surgical strategy for multilevel massive ossification of the posterior longitudinal ligamentsYing-Ching Li0Zhuo-Hao Liu1Zhuo-Hao Liu2Ying-Sheng Li3Mun-Chun Yeap4Yu-Tse Liu5Yin-Cheng Huang6Ching-Chang Chen7Po-Hsun Tu8Po-Hsun Tu9Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, TaiwanSchool of Medicine, National Tsing Hua University, Hsinchu, TaiwanDivision of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, TaiwanDepartment of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, Taoyuan, TaiwanSchool of Medicine, National Tsing Hua University, Hsinchu, TaiwanPurposeCreating enough decompression, favorable outcome, less complication, and maintain adequate lordosis and stability in the patients with cervical myelopathy due to multilevel massive ossification of the posterior longitudinal ligament (OPLL) still poses a challenge for surgeons. The aim of our study is to retrospectively evaluate our patients and try to seek a better surgical strategy.MethodsBetween 2015 and 2019, 55 consecutive patients with multilevel massive OPLL underwent surgical treatment. Among these, 40 patients were treated with cervical laminectomy and then anterior decompression, fusion, and fixation (ADF), which was defined as group 1, and 15 patients were treated with cervical laminectomy and fixation simultaneously, which was defined as group 2. The patient's radiographic characteristics and postoperative outcomes were evaluated.ResultsBetter postoperative cervical sagittal lordosis and less long-term axial pain was achieved in group 1 (p < 0.001), though the functional outcome had no significant difference. In the multivariable analysis, anterior fixation accounts for independent factors for better cervical sagittal alignment (p < 0.001). No complications directly associated with cervical laminectomy were observed.ConclusionIn patients with cervical multilevel massive OPLL, laminectomy at compression level and then ADF depended on the severity and range of compression, but corpectomy of not more than two vertebral bodies is suggested, except K-line (+) and long-segment massive OPLL majorly involving the C2 and posterior laminectomy above and below the OPLL-affected levels with posterior fixation simultaneously.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1066120/fullcervical myelopathylaminectomyoutcomeossification of the posterior longitudinal ligamentsanterior decompression and fixation |
| spellingShingle | Ying-Ching Li Zhuo-Hao Liu Zhuo-Hao Liu Ying-Sheng Li Mun-Chun Yeap Yu-Tse Liu Yin-Cheng Huang Ching-Chang Chen Po-Hsun Tu Po-Hsun Tu The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments Frontiers in Surgery cervical myelopathy laminectomy outcome ossification of the posterior longitudinal ligaments anterior decompression and fixation |
| title | The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments |
| title_full | The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments |
| title_fullStr | The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments |
| title_full_unstemmed | The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments |
| title_short | The surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments |
| title_sort | surgical strategy for multilevel massive ossification of the posterior longitudinal ligaments |
| topic | cervical myelopathy laminectomy outcome ossification of the posterior longitudinal ligaments anterior decompression and fixation |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1066120/full |
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