+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

A novel anterior decompression technique (vertebral body sliding osteotomy) for ossification of posterior longitudinal ligament of the cervical spine



A novel anterior decompression technique (vertebral body sliding osteotomy) for ossification of posterior longitudinal ligament of the cervical spine



Spine Journal 18(6): 1099-1105



Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and is known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery. We introduce a novel anterior decompression technique (vertebral body sliding osteotomy [VBSO]) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL) and evaluate the efficacy and safety of this procedure. This is a case series for novel surgical technique. Fourteen patients (M:F=11:3, mean age 56.9±10) with cervical myelopathy caused by OPLL who underwent VBSO by a single surgeon were included. The surgical outcome was evaluated according to the Japanese Orthopaedic Association score for cervical myelopathy (C-JOA score), and the recovery rate of the C-JOA score was calculated. Patients were also evaluated radiographically with plain and dynamic cervical spine radiographs and pre- and postoperative computed tomography images. Fourteen patients were followed up for more than 24 months, and operation time, estimated blood loss, neurologic outcomes, and surgery-related complications were investigated. Radiological measurements were also performed to analyze the following parameters: (1) canal-occupying ratio and postoperative canal widening, and (2) pre- and postoperative sagittal alignment. The mean recovery rate of C-JOA score at the final follow-up was 68.65±17.8%. There were no perioperative complications, including neurologic deterioration, vertebral artery injury, esophageal injury, graft dislodgement, and CSF leaks, after surgery except for pseudarthrosis in one case. An average spinal canal compromised ratio by OPLL decreased from 61.5±8.1% preoperatively to 16.5±11.2% postoperatively. An average postoperative canal widening was 5.15±1.39 mm, and improvement of cervical alignment was observed in all patients, with average recovery angle of 7.3±6.1° postoperatively. The VBSO allows sufficient decompression of spinal cord and provides excellent neurologic outcomes. Because surgeons do not need to manipulate the OPLL mass directly, this technique could significantly decrease surgery-related complications. Furthermore, as VBSO is based on the multilevel discectomy and fusion technique, it would be more helpful to restore a physiological lordosis.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 047963985

Download citation: RISBibTeXText

PMID: 29496626

DOI: 10.1016/j.spinee.2018.02.022


Related references

Anterior Decompression and Fusion Using Bone Grafts Obtained from Cervical Vertebral Bodies for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine: Technical Note. Neurosurgery 40(4): 866-870, 1997

Anterior decompression and fusion using bone grafts obtained from cervical vertebral bodies for ossification of the posterior longitudinal ligament of the cervical spine: technical note. Neurosurgery 40(4): 866-9; Discussion 869-70, 1997

Updates on ossification of posterior longitudinal ligament. Surgical outcome of anterior decompression and fusion for the ossification of posterior longitudinal ligament of the cervical spine : a comparison with laminoplasty. Clinical Calcium 19(10): 1486-1492, 2009

Anterior decompression for ossification of the posterior longitudinal ligament of the cervical spine. Neurologia Medico-Chirurgica 20(12): 1183-1196, 1980

Anterior decompression for ossification of the posterior longitudinal ligament of the cervical spine. Journal of Neurosurgery 55(1): 108-116, 1981

Anterior decompression for ossification of the posterior longitudinal ligament of the cervical spine. No Shinkei Geka. Neurological Surgery 5(12): 1253-1259, 1977

Anterior longitudinal decompression in the management of severe ossification of the posterior longitudinal ligament in the cervical spine. Orthopedics 37(5): E465, 2014

Anterior radical decompression for severe ossification of the posterior longitudinal ligament in the cervical spine. Zhonghua Wai Ke Za Zhi 46(4): 263-266, 2008

Anterior and Posterior Segmental Decompression and Fusion for Severely Localized Ossification of the Posterior Longitudinal Ligament of the Cervical Spine: Technical Note. Neurologia Medico-Chirurgica 59(6): 238-245, 2019

Ossification of the Ligaments in the Cervical Spine, Including Ossification of the Anterior Longitudinal Ligament, Ossification of the Posterior Longitudinal Ligament, and Ossification of the Ligamentum Flavum. Neurosurgery Clinics of North America 29(1): 63-68, 2018

Ponte Osteotomy During Dekyphosis for Indirect Posterior Decompression With Ossification of the Posterior Longitudinal Ligament of the Thoracic Spine. Clinical Spine Surgery 30(4): E358, 2017

Ponte Osteotomy During Dekyphosis for Indirect Posterior Decompression with Ossification of Posterior Longitudinal Ligament of the Thoracic Spine. Clinical Spine Surgery (): -, 2014

Total (anterior and posterior) decompression of the spinal cord: surgical treatment for combined ossification of the posterior longitudinal ligament and yellow ligament of the thoracic spine. Nihon Seikeigeka Gakkai Zasshi 63(5): 501-506, 1989

Minimally Invasive Anterior Decompression Technique without Instrumented Fusion for Huge Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine: Technical Note And Literature Review. Journal of Korean Neurosurgical Society 60(5): 597-603, 2017

Management and Outcomes of Cerebrospinal Fluid Leak Associated With Anterior Decompression for Cervical Ossification of the Posterior Longitudinal Ligament With or Without Dural Ossification. Journal of Spinal Disorders and Techniques 28(10): 389-393, 2015