Surgical management of cervical ossification of the posterior longitudinal ligament: Natural history and the role of surgical decompression and stabilization

Patrick A. Sugrue*, Jamal McClendon, Ryan J. Halpin, John C. Liu, Tyler R. Koski, Aruna Ganju

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Object: Ossification of the posterior longitudinal ligament (OPLL) is a complex multifactorial disease process combining both metabolic and biomechanical factors. The role for surgical intervention and choice of anterior or posterior approach is controversial. The object of this study was to review the literature and present a single-institution experience with surgical intervention for OPLL. Methods: The authors performed a retrospective review of their institutional experience with surgical intervention for cervical OPLL. They also reviewed the English-language literature regarding the epidemiology, pathophysiology, natural history, and surgical intervention for OPLL. Results: Review of the literature suggests an improved benefit for anterior decompression and stabilization or posterior decompression and stabilization compared with posterior decompression via laminectomy or laminoplasty. Both anterior and posterior approaches are safe and effective means of decompression of cervical stenosis in the setting of OPLL. Conclusions: Anterior cervical decompression and reconstruction is a safe and appropriate treatment for cervical spondylitic myelopathy in the setting of OPLL. For patients with maintained cervical lordosis, posterior cervical decompression and stabilization is advocated. The use of laminectomy or laminoplasty is indicated in patients with preserved cervical lordosis and less than 60% of the spinal canal occupied by calcified ligament in a "hill-shaped" contour.

Original languageEnglish (US)
JournalNeurosurgical focus
Volume30
Issue number3
DOIs
StatePublished - Mar 1 2011

Keywords

  • Cervical spondylitic myelopathy
  • Cervical stenosis
  • Corpectomy
  • Laminoplasty
  • Ossification of the posterior longitudinal ligament

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Surgical management of cervical ossification of the posterior longitudinal ligament: Natural history and the role of surgical decompression and stabilization'. Together they form a unique fingerprint.

Cite this