OBJECTIVE: To investigate factors related to the efficacy of surgery affecting posterior longitudinal ligament ossification of the cervical spine. METHODS: Fifty-three patients with cervical OPLL treated in our hospital from April 2000 to April 2006 were followed up, including 36 males and 17 females. Preoperative JOA scores ranged from 3 to 12, with a mean of 8.5±3.1. The time to neurological symptoms ranged from 2 weeks to 81 weeks, with a mean of 27.4±15.6 weeks. The preoperative CT level of the most compressed segment was selected, and the indexes measured were the area of the developing spinal canal and the area of the ossified ligament, and the ratio of spinal cord compression (area of ossified ligament/area of developing spinal canal) was calculated, and the ratio of enlarged dural sac area in the same segment was measured at follow-up. The surgical approach: 30 cases were posterior only, 14 cases were anterior-posterior, 3 cases were anterior-posterior, and 6 cases were anterior decompression only. The statistical analysis software spss12.0 was used to conduct multivariate correlation analysis between the spinal cord compression ratio, postoperative spinal cord area enlargement ratio, choice of surgical approach, patient’s age, and time of neurological symptoms and the improvement rate of JOA score after surgery, and the correlation coefficients were derived to screen out the indicators related to the efficacy. RESULTS: The follow-up period was 29-101 months, with a mean of 46±16 months. The postoperative improvement rate was 28-68%, with a mean of 52.8±10.5. The analysis showed that there was a correlation between the spinal cord compression ratio, preoperative JOA score, patient’s age at the time of surgery and the postoperative JOA score improvement rate, and there was no significant correlation between the surgical approach, duration of symptoms, and postoperative spinal canal area enlargement ratio and the efficacy. CONCLUSION: Surgery is recommended for patients with posterior longitudinal ligamentous ossification of the cervical spine once neurological symptoms develop. Patients can get more satisfactory results with either anterior or posterior surgery. Zhang Qingming, Department of Orthopedics, Xuanwu Hospital, Capital Medical University
[Keywords] Cervical spine; posterior longitudinal ligament ossification; surgical treatment