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http://dx.doi.org/10.3340/jkns.2010.48.4.335

Single Stage Circumferential Cervical Surgery (Selective Anterior Cervical Corpectomy with Fusion and Laminoplasty) for Multilevel Ossification of the Posterior Longitudinal Ligament with Spinal Cord Ischemia on MRI  

Son, Seong (Department of Neurosurgery, Gachon University of Medicine and Science, Gil Hospital)
Lee, Sang-Gu (Department of Neurosurgery, Gachon University of Medicine and Science, Gil Hospital)
Yoo, Chan-Jong (Department of Neurosurgery, Gachon University of Medicine and Science, Gil Hospital)
Park, Chan-Woo (Department of Neurosurgery, Gachon University of Medicine and Science, Gil Hospital)
Kim, Woo-Kyung (Department of Neurosurgery, Gachon University of Medicine and Science, Gil Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.48, no.4, 2010 , pp. 335-341 More about this Journal
Abstract
Objective : Anterior cervical corpectomy with fusion (ACF) or laminoplasty may be associated with substantial number of complications for treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL) with significant cord compression. For more safe decompression and stabilization in multilevel cervical OPLL with prominent cord compression, we propose circumferential cervical surgery (selective ACF and laminoplasty) based on our favorable experience. Methods : Twelve patients with cervical myelopathy underwent circumferential cervical surgery and all patients showed multilevel OPLL with Signal change of the spinal cord on magnetic resonance imaging (MRI). A retrospective review of clinical, radiological. and surgical data was conducted. Results : There were 9 men and 3 women with mean age of 56.7 years and a mean follow up period of 15.6 months. The average corpectomy level was 1.16 and laminoplasty level was 4.58. The average Japanese Orthopedic Association score for recovery was 5.1 points and good clinical results were obtained in 11 patients (92%) (p < 0.05). The average space available for the cord improved from 58.2% to 87.9% and the average Cobb's angle changed from 7.63 to 12.27 at 6 months after operation without failure of fusion (p < 0.05). Average operation time was 8.36 hours, with an estimated blood loss of 760 mL and duration of bed rest of 2.0 days. There were no incidences of significant surgical complications, including wound infection. Conclusion : Although the current study examined a small sample with relatively short-term follow-up periods, our study results demonstrate that circumferential cervical surgery is considered favorable for safety and effectiveness in multilevel OPLL with prominent cord compression.
Keywords
Ossification of the posterior longitudinal ligament; Anterior cervical corpectomy with fusion; Laminoplasty; Japanese Orthopedic Association score;
Citations & Related Records
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1 Chiba K, Ogawa Y, Ishii K, T akaishi H, Nakamura M, Maruiwa H, et aI. : Long-term results of expansive open-door laminoplasty for cervical myelopathy--average 14-year follow-up study. Spine (Phila Pa 1976) 31: 2998-3005, 2006   DOI   ScienceOn
2 Tani T, Ushida T, Ishida K, Iai H, Noguchi T, Yamamoto H : Relative safety of anterior microsurgical decompression versus laminoplasty for cervical myelopathy with a massive ossified posterior longitudinal ligament. Spine (Phila Pa 1976) 27: 2491-2498, 2002   DOI   ScienceOn
3 Iwasaki M, Okuda S, Miyauchi A, Sakaura H, Mukai Y, Yonenobu K, et al. : Surgical strategy for cervical myelopahty due to ossification of the posterior longitudinal ligament : Part 2 : Advantages of anterior decompression and fusion over laminoplasty. Spine (Phila Pa 1976) 32: 654-660, 2007   DOI   ScienceOn
4 Gok B, Sciubba DM, Mcloughlin GS, McGirt M, Ayhan S, Wolinsky JP, et al. : Surgical treatment of cervical spondylotic myelopathy with anterior compression: a review of 67 cases. J Neurosurg Spine 9 : 152-157, 2008   DOI   ScienceOn
5 Yonenobu K, Hosono N, Iwasaki M, Asano M, Ono K: Neurologic complications of surgery for cervical compression myelopathy. Spine (Phila Pa 1976) 16: 1277-1282, 1991   DOI   ScienceOn
6 Iwasaki M, Okuda S, Miyauchi A, Sakaura H, Mukai Y, Yonenobu K, et al. : Surgical strategy for cervical myelopahty due to ossification of the posterior longitudinal ligament : Part 1 : Clinical results and limitations of laminoplasty. Spine (Phila Pa 1976) 32: 647-653, 2007   DOI   ScienceOn
7 Iwasaki M, Kawaguchi Y, Kimura T, Yonenobu K: Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: More than 10 years follow up. J Neurosurg 96: 180-189,2002
8 Vaccaro AR, Falatyn SP, Scuderi GJ, Eismont FJ, McGuire RA, Singh K, et al. : Early failure of long segment anterior cervical plate fixation. J Spinal Disord 11 : 410-415, 1998
9 Vitarbo E, Sheth RN, Levi AD : Open-door expansile cervical laminoplasty. Neurosurgery 60 : S154-S159, 2007
10 Wiggins GC, Shaffrey CI : Dorsal surgery for myelopathy and myeloradiculopathy. Neurosurgery 60 : S71-S81, 2007
11 Cloward RB : The anterior approach for removal of ruptured cervical disks. J Neurosurg 15: 602-617,1958   DOI
12 Epstein NE : Circumferential cervical surgery for ossification of the posterior longitudinal ligament : a multianalytic outcome study. Spine (Phila Pa 1976) 29: 1340-1345,2004   DOI   ScienceOn
13 Sasso RC, Ruggiero RA Jr, Reilly TM, Hall PV : Early reconstruction failures after multilevel cervical corpectomy. Spine 28 : 140-142, 2003   DOI   ScienceOn
14 Sim SJ, Cho JH, Yoo SI, Kown YD, Lee YS : Clinical analysis of postoperative prognostic factors of cervical anterior decompression and interbody fusion for OPLL. J Korean Neurosurg Soc 29: 360-364, 2000
15 Dai L, Ni B, Yuan W, Jia L : Radiculopathy after laminectomy for cervical compression myelopathy. J Bone Joint Surg Br 80 : 846-849, 1998   DOI   ScienceOn
16 Stewart TJ, Schlenk RP, Benzel EC : Multiple level discectomy and fusion, Neurosurgery 60 : S143-S148, 2007
17 Ozgen S, Naderi S, Ozek MM, Pamir MN : A recrospective review of cervical corpectomy : indications, complications and outcome. Acta Neurochir (Wien) 146 : 1099-1105; discussion 1105, 2004   DOI   ScienceOn
18 Robinson RA, Smith GW : Anterolateral cervical disk removal and interbody fusion for cervical disk syndrome. Bull Johns Hopkins Hosp 96: 223-224,1955
19 Epstein N : Ossification of the cervical posterior longirudinalligament: a review. Neurosurg Focus 13 : ECP 1, 2002
20 Ogawa, Y, Toyama Y, Chiba K, Matsrnnoto M, Nakamura M, Takaishi H, et al. : Long-term results of expansive open-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine. J Neurosurg Spine 1: 168-174, 2004   DOI   ScienceOn
21 Kawaguchi Y, Kanamori M, Ishihara H, Ohmori K, Nakamura H, Kimura T : Minimum 10-year followup after en bloc cervical laminoplasty. Clin Orthop Relat Res: 129-139, 2003
22 Nakase H, Park YS, Kimura H, Sakaki T, Morimoto T: Complications and long-term follow-up results in titanium mesh cage reconstruction after cervical corpectomy. J Spinal Disord Tech 19: 353-357, 2006   DOI   ScienceOn
23 Chiba K, Yamamoto I, Hitabayashi H, Iwasaki M, Goto H, Yonenobu K, et al. : Multicenter study investigating the postoperative progression of ossification of the posterior longitudinal ligament in the cervical spine: a new computer-assisted measurement. J Neurosurg Spine 3: 17-23, 2005   DOI   ScienceOn
24 Mummaneni PV, Haid RW, Rodts GE Jr : Combined ventral and dorsal surgery for myelopathy and myeloradiculopathy. Neurosurgery 60: S82-S89, 2007
25 Bazaz R, Lee MJ, Yoo JU : Incidence of dysphagia after anterior cervical spine surgery : a prospective study. Spine (Phila Pa 1976) 27 : 2453-2458,2002   DOI   ScienceOn
26 Mayr MT, Subach BR, Corney CH, Rodts GE, Haid RW Jr: Cervical spinal stenosis: outcome after anterior corpectomy, allograft reconstruction, and instrumentation. J Neurosurg 96: 10-16, 2002
27 Kim YS, Chin DK, Cho YE, Jin BH, Yoon YS, Park JP, et al. : Surgical treatment for ossification of the posterior longitudinal ligament of the cervical spine. J Korean Neurosurg Soc 26: 1237-1245, 1997
28 Matz PG, Pritchard PR, Hadley MN : Anterior cervical approach for the treatment of cervical myelopathy. Neurosurgery 60 : S64-S70, 2007
29 Kim JG, Kim SW, Lee SM, Shin H : Surgical result of the combined anterior and posterior approach in treatment of cervical spondylotic myeolopathy. J Korean Neurosurg Soc 39 : 188-191, 2006   과학기술학회마을
30 Kawaguchi Y, Kanamori M, Ishihara H, Nakamura H, Sugimori K, Tsuji H, et al. : Progression of ossification of the posterior longitudinal ligament following en bloc cervical laminoplasty. J Bone Joint Surg Am 83-A: 1798-1802, 2001