Multicenter Study Of Three Different Methods Of Surgical Treatment For Long Segment Ossification Of Cervical Posterior Longitudinal Ligament

OBJECTIVE:To discuss and analyze three kinds of surgical (Anterior cervicalcorpectomy,removal or partial removal of ossification foci,interbody implantfusion;Posterior open-door laminoplasty,decompression,bone graft and internalfixation;Posterior open-door laminoplasty) treatments effect on long-segment cervicalossification of the posterior longitudinal ligament.It could provide a reference foroperative select.METHODS: It was a retrospective analysis of the54cases of ossification of theposterior longitudinal ligament of clinical data，that was collected in the The first hospitalaffiliated Jinan university,Second Xiangya Hospital, The Affiliated Hospital of NanhuaUniversity during the time Jan.2006-Jan.2010.Age of41to78years，average65.5yearsold,which involved24men and30women.20cases undergoing anterior cervicalcorpectomy,removal or partial removal of ossification foci,interbody implant fusion asgroup A,26receiving posterior open-door laminoplasty,decompression,bone graft andinternal fixation as group B,and8undergoing posterior open-door laminoplasty withoutinternal fixation as group C.Patients were followed up for6months to5years,2.4yearson average.Lateral cervical spine X-ray,CT scan and MRI examinations were routinelytaken preoperatively.Results of operations according to JOA scoring system,which wasformulated by Japanese Orthopaedic Association,were evaluated.Neurological functionwas evaluated on preoperatively,and lw,ly postoperatively,and the improvementrates were also calculated.The data was evaluated by SPSS l3.0analysis software.The difference was statistical significance when P<0.05. Surgical complications and factorsaffecting the surgical results were also recorded.Results:1week after treatment,the mean amelioration rate was51.04%in groupA,70.87%in group B,65.73%in group C.There was1case with dural tear in group A,there have significant difference between anterior and posterior approach,and but therewas no significant difference between Group B and Group C.1year after treatment,themean amelioration rate was75.87%in group A,78.90%in group B,76.94%in group C,there was no significant difference between each Group.There was1case with duraltear in group A,1case of recurrent laryngeal nerve temporary palsy occurred,1casehad Hematoma,and1case got Carotid sinus injury; In group B,1case had dural tear,1case had C5nerve root palsy; In group C, posterior axis of symptoms occurred in2cases,1case of Lamina secondary closed.Conclusion:1.Use anterior cervical corpectomy,removal or partial removal ofossification foci,interbody implant fusion and posterior open-door laminoplasty,decompression,bone graft and internal fixation and posterior open-door laminoplastytreat long-segment OPLL, three procedures are given a good effect;2.Short-termfollow-up to improve the rate of anterior and posterior surgical procedure have differencebetween anterior and posterior approach,but1year after treatment, the amelioration ratewas no significant difference between each methods;3. For long-segmentOPLL,posterior open-door laminoplasty, decompression,bone graft and internal fixationwith few complications,it safe and effective.