The Clinical Significance Of The Resection Of Posterior Longitudinal Ligament In The Cervical Subtotal Vertebrectomy

Objective:to discuss the clinic significance of treament for Ossification of posterior Longitudinal Ligament by anterior surgery with anterior cervical vertebral subtotal vertebrectomy and posterior longitudinal ligament excision.Method:Analysing the cases of cervical ossification of the posterior longitudinal ligament during six years (from Junary,2005 to October,2010) treated by anterior cervical vertebral subtotal vertebrectomy in Spine Department, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, the author collected 44 patients with complete date and meeting the criteria after the surgery by means of telephone, mail and out-patient and then divided them into group A and group B. Group A includes 21 cases of anterior cervical vertebral subtotal vertebrectomy with synmesh fixation implanted under the bone, and group B includes 23 cases of anterior cervical vertebral subtotal vertebrectomy and posterior longitudinal ligament excision with synmesh fixation implanted under the bone. The follow-up period was 6-72 months, in which the author compared the improvement rate of the both groups and evaluated the two curative effect according to pre- and postoperative spinal cord JOA scores. Meanwhile, the patients' age, the course of disease, the degree of pathologicalprocess were also analysed in the article.Result:comparison of sex, age, courseofdisease, pathologicalprocess, length of stay,number of treatment and preoperative JOA scores shows no difference between longitudinal ligament reainment and excision. However, the spinal cord function and neurological symptoms of the both two groups after surgery were improved to some extent. Moreover, there exists marked difference of improvement rate between two group:after surgery,the JOA score,goodness and improvement rate of patients with posterior longitudinal ligament excision (group A) are higher than the retained ones (groupB).Conclusion:Under the premise of the scientific and accurate operating with strictly mastering indications, to treat the patient with cervical vertebra whose spinal cord is compressed because of proliferation of hypertrophic posterior longitudinal ligament with anterior cervical vertebral subtotal vertebrectomy and posterior longitudinal ligament excision, and complete decompression, may receive a better clinical efficacy.