Cervical Curvature, Spinal Cord MRIT2Signal, And Occupying Ratio Impact Surgical Approach Selection In Patients With Ossification Of The Posterior Longitudinal Ligament

Objective:Factors impacting surgical options and outcomes in patients with cervical ossification of the posterior longitudinal ligament (OPLL) were explored.Methods:The surgical options of127patients,who suffered from ossification of cervical posterior longitudinal ligament and underwent surgical therapy in department of orthopedics of Qilu Hospital from2008to2012,were discussed objectively in the research. All the selected patients includes61males and66females.The ages of them ranged from40to70,which were55.2in average.Among all the cases,68patients underwent anterior cervical corpectomy and59patients underwent posterior cervical double door laminoplasty. The influence on surgical options,which was put by preoperative cervical curvature and spinal cord signal in T2-weighted MRI images,was analysed.Results:The anterior surgery increased the cervical curvature and corrected the cervical kyphosis (10.3%),but meanwhile increased the incidence of the esophageal stenosis(50%);compared to posterior surgery, anterior surgery provided better symptom improvement in the short term (P>0.001);if there existed high spinal cord signal in the preoperative T2-weighted MRI images,the postoperative neurological improvement in the short term was not significant (P=0.0434) and showed no significant deferences between anterior and posterior surgery;when it came to1week and1year after operation,the anterior surgery bad better therapeutic effects than the posterior surgery.(1week after operation P=0.7564,1year after operation P=0.0071);1year after operation,5cases of the anterior surgery suffered complications and3cases of the anterior surgery suffered complications.Conclusions:preoperative assessment of cervical curvature and spinal cord signal in the T2-weighted MRI images can provide effective guidance for the surgical options and prognosis judgement.