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| YIN Fei,ZHU Qingsan,ZHAO Dongxu.Indication of resection of posterior longitudinal ligament in anterior decompression for cervical spondylotic myelopathy[J].Chinese Journal of Spine and Spinal Cord,2013,(5):445-448. |
| Indication of resection of posterior longitudinal ligament in anterior decompression for cervical spondylotic myelopathy |
| Received:August 29, 2012 Revised:January 15, 2013 |
| English Keywords:Cervical spondylosis Anterior operation Posterior longitudinal ligament resection |
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| English Abstract: |
| 【Abstract】 Objectives: To discuss the indication of resection of posterior longitudinal ligament(PLL) during the anterior decompression for cervical spondylotic myelopathy. Methods: 500 patients with cervical spondylotic myelopathy treated anteriorly from June 2000 to June 2010 were retrospectively reviewed. Resection of PLL was performed in 213 cases, including 153 males and 60 females with a mean age of 50 years(range, 30-74 years). Clinical data and outcome were analyzed. Results: Among the 213 cases, calcification of the posterior longitudinal ligament or disc was found in 178 cases. Loss of elasticity was noted during the operation in 30 cases. The disc herniation was found penetrated into the dual matter in 1 case, which surrounded by the signal of cerebrospinal fluid, and not penetrating the the dual in 4 cases, all these were found during the operation. 3 cases suffered from postoperative cerebrospinal fluid leakage, which was cured by conservative treatment. 2 cases were complicated with epidural hematoma which led to neurological deficit and was resolved 1 month later by immediate reoperation. 2 cases suffering from esophageal injury were cured by conservative treatment for 4-6 weeks. All cases were followed up for 36.7 months(range, 6-70 months). The improvement rate was 60.00% (range, 7.69%-100%). JOA score improved from 8.71±3.36(range, 4-14) to 13.50±3.50(range, 5-17). There was significant difference of JOA score between pre- and postoperation(P<0.05). Conclusions: Preoperative characteristics in radiograph and intraoperative palpation of PLL can be used to determine the necessity of resection of PLL, complications may be encountered during this procedure, which should be paid attention. |
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