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Choice of surgical approach for ossification of the posterior longitudinal ligament in combination with cervical disc hernia

Ossification of the posterior longitudinal ligament (OPLL) is a common spinal disorder that presents with or without cervical myelopathy. Furthermore, there is evidence suggesting that OPLL often coexists with cervical disc hernia (CDH), and that the latter is the more important compression factor. To raise the awareness of CDH in OPLL for spinal surgeons, we performed a retrospective study on 142 patients with radiologically proven OPLL who had received surgery between January 2004 and January 2008 in our hospital. Plain radiograph, three-dimensional computed tomography construction (3D CT), and magnetic resonance imaging (MRI) of the cervical spine were all performed. Twenty-six patients with obvious CDH (15 of segmental-type, nine of mixed-type, two of continuous-type) were selected via clinical and radiographic features, and intraoperative findings. By MRI, the most commonly involved level was C5/6, followed by C3/4, C4/5, and C6/7. The areas of greatest spinal cord compression were at the disc levels because of herniated cervical discs. Eight patients were decompressed via anterior cervical discectomy and fusion (ACDF), 13 patients via anterior cervical corpectomy and fusion (ACCF), and five patients via ACDF combined with posterior laminectomy and fusion. The outcomes were all favorable. In conclusion, surgeons should consider the potential for CDH when performing spinal cord decompression and deciding the surgical approach in patients presenting with OPLL

Keywords : Aged,Cervical Vertebrae,Chi-Square Distribution,China,complications,diagnostic imaging,Diskectomy,Female,Hernia,Humans,Intervertebral Disc Displacement,Laminectomy,Magnetic Resonance Imaging,Male,methods,Middle Aged,Ossification of Posterior Longitudinal Ligament,Patients,Radiography,Retrospective Studies,Severity of Illness Index,Spinal Cord,Spinal Cord Compression,Spinal Fusion,Spine,surgery,, Surgical,Approach,Ossification, pharmacierge pharmacy

Date of Publication : 2010 Mar

Authors : Yang HS;Chen DY;Lu XH;Yang LL;Yan WJ;Yuan W;Chen Y;

Organisation : Department of Orthopaedic Surgery, Changzheng Hospital, No. 415 Feng Yang Road, 200003 Shanghai, China

Journal of Publication : Eur Spine J

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/20012451

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