Advances in surgical strategies for ossification of posterior longitudinal ligament involving the C 2 segment.
10.7507/1002-1892.202302039
- Author:
Teng LIU
1
;
Guoning GU
1
;
Chenguang ZHAN
1
;
Haishan LI
1
;
Huizhi GUO
2
;
Yongxian LI
2
;
Guoye MO
2
;
Kai YUAN
2
;
Shuncong ZHANG
2
;
Zhidong YANG
2
;
Yongchao TANG
2
Author Information
1. The First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China.
2. Department of Spinal Orthopedics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510407, P. R. China.
- Publication Type:Journal Article
- Keywords:
C2;
Ossification of the posterior longitudinal ligament;
cervical spondylotic myelopathy;
surgical strategy
- MeSH:
Humans;
Longitudinal Ligaments/surgery*;
Ossification of Posterior Longitudinal Ligament/surgery*;
Treatment Outcome;
Osteogenesis;
Decompression, Surgical/methods*;
Cervical Vertebrae/surgery*;
Laminoplasty/methods*;
Kyphosis/surgery*;
Retrospective Studies
- From:
Chinese Journal of Reparative and Reconstructive Surgery
2023;37(6):742-747
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the application of surgical strategies for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) involving the C 2 segment.
METHODS:The literature about the surgery for cervical OPLL involving C 2 segment was reviewed, and the indications, advantages, and disadvantages of surgery were summarized.
RESULTS:For cervical OPLL involving the C 2 segments, laminectomy is suitable for patients with OPLL involving multiple segments, often combined with screw fixation, and has the advantages of adequate decompression and restoration of cervical curvature, with the disadvantages of loss of cervical fixed segmental mobility. Canal-expansive laminoplasty is suitable for patients with positive K-line and has the advantages of simple operation and preservation of cervical segmental mobility, and the disadvantages include progression of ossification, axial symptoms, and fracture of the portal axis. Dome-like laminoplasty is suitable for patients without kyphosis/cervical instability and with negative R-line, and can reduce the occurrence of axial symptoms, with the disadvantage of limited decompression. The Shelter technique is suitable for patients with single/double segments and canal encroachment >50% and allows for direct decompression, but is technically demanding and involves risk of dural tear and nerve injury. Double-dome laminoplasty is suitable for patients without kyphosis/cervical instability. Its advantages are the reduction of damage to the cervical semispinal muscles and attachment points and maintenance of cervical curvature, but there is progress in postoperative ossification.
CONCLUSION:OPLL involving the C 2 segment is a complex subtype of cervical OPLL, which is mainly treated through posterior surgery. However, the degree of spinal cord floatation is limited, and with the progress of ossification, the long-term effectiveness is poor. More research is needed to address the etiology of OPLL and to establish a systematic treatment strategy for cervical OPLL involving the C 2 segment.
