The Contrast Analysis And Selection Of The Anterior And Posterior Approach Surgery For Ossification Of The Posterior Longitudinal Ligament

Objective:To observe and summary of the posterior longitudinal ligament of ossification of the clinical manifestations and imaging performance, through comparing the anterior and the posterior approach of curative effect, analyzing influencing factors and causes of postoperative complications, it could provide a reference for operative select. According to the patient's age, history, ossification type, spinal cord dysfunction and economic circumstances, etc, we should select an individualized, simple and effective operation approach.Methods:It was a retrospective analysis of the 54 cases of ossification of the posterior longitudinal ligament of clinical data, that was collected in the Second Affiliated Hospital of Dalian Medical University during the time 2006-2010.Using the Japanese Orthopaedic Association ratings system and Hirabayashi method,to compare anterior and posterior approach of neural function and the postoperative effects; The postoperative effects and related factor were evaluated by SPSS13.0 analysis software. The difference was statistical significance when P<0.05.Results:(1) follow-up time 3 months to 4 years, an average of 33 months, anterior group, relapse 2 cases, surgical group,1 case of recurrence.(2) two sets of postoperative improving conditions were analyzed statistically by more classification situations (2×C) ofχ2-test, P> 0.05.The curative effect between the anterior group and the posterior group was the same as the overall probability distribution; the two groups of JOA score improvement rate after postoperative 7-days and final follow-up have no significant differences. The anterior and posterior approach postoperative JOA score after postoperative 7-day and end-follow-up were analyzed independently by the t-test, P<0.05; both the anterior and posterior surgery of preoperative and postoperative JOA ratings were analyzed statistically by t-test, P<0.05.(3) The study on the efficacy and patient age, history, preoperative JOA scores for linear correlation analysis, showed that course and age were negative to efficacy, and preoperative JOA scores were positive relation-ship.Conclusion:(1) In the lesions of the range less than three vertebrae in cases of OPLL, the anterior and posterior surgery was compared respectively. Its effects had no significant differences.(2) For single-segment OPLL, anterior surgery was preferred. Especially in the front of the pressure from large cases, anterior approach was better.(3) The anterior and posterior surgery after postoperative 7-days of improvement rate was lower than literature reported.Recently postoperative improving rate would increase and then stabilize gradually. there would be a downward trend in the later.(4) The posterior longitudinal ligament of the ossification of surgical treatment should be early, this is the key to improving surgical outcomes.