Anterior approach or combined anterior and posterior approaches for severe ossification of cervical posterior longitudinal ligament

Liu Chun-yu; Jin Li; Peng Bao-gan

doi:10.3969/j.issn.2095-4344.2014.04.008

Abstract：BACKGROUND:It is controversial whether anterior approach alone, or combined anterior and posterior approaches were used for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament. <br> OBJECTIVE:To explore the difference of anterior approach versus combined anterior and posterior approaches for the treatment of high level and multiple segments of severe ossification of cervical posterior longitudinal ligament. <br> METHODS:A total of 21 cases of high level and multiple segments of severe ossification of cervical posterior longitudinal ligament were included in this study. There were 9 males, aged 56-72 years, and 12 females, aged 58-70 years. We used anterior decompression and titanium mesh bone graft fusion in 11 cases which lesion located between C2-5 vertebra, and ossification excision, combined anterior (titanium mesh plate and screw) and posterior (lateral mass screw) approaches in 10 cases which between C3-7 vertebra. Japanese Orthopaedic Association score system was used to evaluate the results. The excellent and good rate and improvement rate were calculated. <br> RESULTS AND CONCLUSION:The excellent and good rate was 90%and improvement rate was 82%in 10 cases using combined anterior and posterior approaches. The excellent and good rate was 73%and improvement rate was 73%in 11 cases using anterior treatment alone. Significant differences in the excellent and good rate and improvement rate were detected between the two groups (P<0.05). These suggested that combined anterior and posterior approaches for high level and multiple segments of severe ossification of cervical posterior longitudinal ligament is a better operative procedure.