Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach

CORC > 厦门大学 > 医学院－已发表论文

	Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach
	Lin, Dasheng ; Ding, Zhenqi ; Lian, Kejian ; Hong, Jiayuan ; Zhai, Wenliang ; Lin DS(林达生) ; Ding ZQ(丁真奇) ; Lian KJ(练克俭) ; Zhai WL(翟文亮)
刊名	http://dx.doi.org/10.4103/0019-5413.91642
	2012
关键词	OPEN-DOOR LAMINOPLASTY FOLLOW-UP SURGICAL STRATEGY SPINAL-CORD MYELOPATHY FUSION CORPECTOMY DECOMPRESSION COMPRESSION DISKECTOMY
英文摘要	Background: The optimal approach to provide satisfactory decompression and minimize complications for ossification of the posterior longitudinal ligament (OPLL) involving multiple levels (3 levels or more) remains controversial. The purpose of this study was to compare the results of two surgical approaches for cervical OPLL involving multiple levels; anterior direct decompression and fixation, and posterior indirect decompression and fixation. We present a retrospective review of 56 cases followed at a single Institution. Materials and Methods: We compared patients of multiple levels cervical OPLL that were treated at a single institution either with anterior direct decompression and fixation or with posterior indirect decompression and fixation. The clinical records of the patients with a minimum duration of follow-up of 2 years were reviewed. The associated complications were recorded. Results: Fifty-six patients constitute the clinical material. 26 cases were treated by anterior corpectomy and fixation and 30 cases received posterior laminectomy and fixation. The two populations were similar. It was found that both anterior and posterior decompression and fixation can achieve satisfactory outcomes, and posterior surgery was accomplished in a shorter period of time with lesser blood loss. Although patients had comparable preoperative Japanese Orthopaedics Association (JOA) scores, those with a canal occupancy by OPLL more than 50 and managed anteriorly had better outcomes. However, for those with more severe stenosis, anterior approach was more difficult and associated with higher risks and complications. Despite its limitations in patients with high occupancy OPLLs, through the multiple level laminectomy, posterior fixation can achieve effective decompression, maintaining or restoring stability of the cervical spine, and thereby improving neural outcome and preventing the progression of OPLL. Conclusions: The posterior indirect decompression and fixation has now been adopted as the primary treatment for cervical OPLL involving multiple levels with the canal occupancy by OPLL < 50 at our institution because this approach leads to significantly less implant failures. Those patients with the occupancy >= 50 managed with anterior approach surgeries had better outcomes, but approach was more difficult and associated with higher risk and complications.
语种	英语
出版者	INDIAN J ORTHOP
内容类型	期刊论文
源URL	[http://dspace.xmu.edu.cn/handle/2288/93129]
专题	医学院－已发表论文
推荐引用方式 GB/T 7714	Lin, Dasheng,Ding, Zhenqi,Lian, Kejian,et al. Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach[J]. http://dx.doi.org/10.4103/0019-5413.91642,2012.
APA	Lin, Dasheng.,Ding, Zhenqi.,Lian, Kejian.,Hong, Jiayuan.,Zhai, Wenliang.,...&翟文亮.(2012).Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach.http://dx.doi.org/10.4103/0019-5413.91642.
MLA	Lin, Dasheng,et al."Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approach".http://dx.doi.org/10.4103/0019-5413.91642 (2012).