Anterior decompression for cervical spondylosis associated with an early form of cervical ossification of the posterior longitudinal ligament.

OBJECT: The goal of this study was to determine the appropriate surgical strategy for cervical spondylosis associated with an early form of ossification of the posterior longitudinal ligament (EOPLL) of the cervical spine.

METHODS

Patients with EOPLL-associated cervical spondyosis were selected for treatment. Medical records and radiographs were retrospectively reviewed. Specimens taken at the time of operation were histologically examined. There were 24 men and six women ranging in age from 39 to 74 years (mean 57.6 years). Symptoms consisted of myelopathy in 28 cases and radiculopathy in two cases. Anterior decompressive surgery was performed. The EOPLL, hypertrophy of the posterior longitudinal ligament (HPLL), and the disc-PLL complex were directly resected. The mean preoperative Japan Orthopaedic Association score was 12.6, and the mean postoperative score was 14.4. Histologically, EOPLL was consistent with foci of compact lamellar bone in the degenerative thickening of the PLL.

CONCLUSIONS

Appropriate corpectomy should follow direct removal of EOPLL associated with HPLL compressing the spinal cord to achieve good outcomes.