Preliminary Clinical Studies On Postoperative Progression Of The Posterior Longitudinal Ligament

Part I Postoperative progression and its analysis of ossification of the posterior longitudinal ligament on cervical spineObjective:To observe the cervical posterior longitudinal ligament in patients with postoperative progress ossification of the posterior longitudinal ligament.Methods:Retrospective study of surgical treatment from January2007to December2011,79cases of cervical OPLL patients,48cases were male and31female; aged34-76years, mean56.3years; follow-up time1-4years, an average of2.6years.34cases of anterior cervical, posterior cervical laminectomy fixation in45cases. Ossification progress is measured based on the preoperative, cervical X piece in the postoperative follow-up, three-dimensional CT and MRI imaging data.Results:79patients were followed up patients, ossification progress in42cases, the hybrid21cases, the Continuous13cases, segmental eight cases. Growth ossification matter for more than2mm as standard, simply ossification longitudinal progress in four cases; ossification of the longitudinal, transverse progress in36cases; simply ossification transverse progress two cases. Ossification vertical progress3-16mm, average (7.74±4.71) mm; the ossification horizontal progress2-5mm average (2.67±1.51) mm. Ossification progress in1year after9cases,16cases,11cases in three years in the two years, four years, six cases.Conclusion:The higher cervical posterior longitudinal ligament ossification in patients with postoperative ossification progress rate.1year postoperatively, the horizontal and vertical ossification rate of progress faster;2years postoperative lateral progress slowed;3years after surgery, the longitudinal progress stabilized. Part Ⅱ Factors for the ossification progress of the OPLL patients on cervical spineObjective:To study cervical posterior longitudinal ligament ossification in patients with ossification of progress influencing factors. Methods:Retrospective study of surgical treatment from January2007to December2011,79cases of cervical OPLL patients, and the relationship between gender, age, OPLL typing, the follow-up time, the surgical approach and ossification postoperative progress through statistical analysis.Results:79cases of cervical OPLL patients with postoperative follow-up, postoperative ossification progress in42cases, including48cases of male and31female; surgery, age34-76years, mean55.9years; aged less than49years old in16cases50-59-year-old,12cases,10cases,60-69-year-old, older than70years old. Based on the OPLL classification:21cases of mixed type, Continuous13cases, segmental eight cases; the cervical OPLL posterior ossification progress after surgery,36cases of anterior surgery for ossification progress6cases, of which1year postoperatively ossification progress occurs in9cases,16cases in two years,11cases in three years, four years six cases.Conclusion:cervical OPLL ossification progress after considerable incidence, especially younger, line and posterior cervical spine surgery, and preoperative patients with mixed progress rate is higher.1year postoperatively, the horizontal and vertical ossification rate of progress faster;2years postoperative lateral progress slowed;3years after surgery, the longitudinal progress stabilized. Part Ⅲ Cervical ossification of the posterior longitudinal ligament: Anterior versus posterior approachObjective:To compare the anterior and posterior surgical treatment of cervical OPLL short-term efficacy, and the effect of treatment-related factors were analyzed.Methods:Retrospective study of surgical treatment from January2007to December2011,46cases of patients with cervical OPLL, anterior cervical surgery16cases,30cases of posterior cervical laminectomy fixation. The comparative analysis of the short-term efficacy of the two surgical complications. posterior decompression fixed all can achieve satisfactory outcomes, shorter operative time and blood loss less posterior surgery. Canal compromise for the ossification of the posterior longitudinal ligament ossification matter more than more than50%of the patients, better JO As score after anterior surgery recovery. However, for patients with more serious spinal canal narrow anterior surgery is more difficult, the greater the risk of surgery, a higher incidence of complications. These OPLL patients, resection and internal fixation through multi-segment posterior lamina can achieve effective decompression, to maintain or restore the stability of the cervical spine, thus improving neurological function and prevent the ossification of the posterior longitudinal ligament progress.Conclusion:The results of this study show that for strict to select indications cervical OPLL cases, anterior surgery is relatively safe, and the short-term follow-up neurological recovery effects and imaging evaluation is superior posterior. For canal compromise rate>50%of patients, the anterior approach surgery have better outcomes, but the difficult surgical operation, greater risk of surgery, a higher incidence of complications.