Abstract:

BACKGROUND: Multilevel cervical disc herniation accompanying ossification of posterior longitudinal ligament (OPLL) can seriously hurt the spinal cord. Which way of operative approach is more preferable is still uncertain. Whether one-stage combined anterior and posterior operation can achieve better effects remains unclear.
OBJECTIVE: To explore the therapeutic effect of one-stage anterior and posterior operation for the treatment of multilevel cervical disc herniation accompanying OPLL.
METHODS: Seventeen patients with multilevel cervical disc herniation and OPLL were treated by one-stage anterior and posterior operation at the Department of Orthopaedics, Tongji Hospital, were selected, including 11 males and 6 females, aged 42-74 years, mean aged 51.5 years. X-ray film, CT or MRI before operation showed the cervical cord was compressed by the multilevel herniated cervical discs or the ossified posterior longitudinal ligament. The stability and fusion of the injured segments were observed by regular postoperative X-ray film.
RESULTS AND CONCLUSION: All patients were received a 6-36 months follow-up (24.5 months on average). The postoperative JOA scores were (12.88±2.47) points, which was greater than that of preoperatively [(6.41±1.28) points, P < 0.05]. The improvement-rate of the spinal function after 6 months included 5 excellent cases, 7 good cases, and 4 fair cases. The excellent-good rate was 71%. All the patients got completely reduction, and all grafts got fused at 3-4 months after operation. The cervical intervertebral height and lordosis were satisfied maintained and there was no complication related to internal fixation breakage, loosening or displacement. It suggested that one-stage anterior and posterior operation can provide satisfied decompression earlier and rebuild the spinal stability in time, which is a safe and effective surgical intervention for multilevel cervical spondylotic myelopathy accompanying OPLL.