Surgery for ossification of the posterior longitudinal ligament of the cervical spine

The authors present their surgical experience with fifty seven cases of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, operated between January 1992 and January 1999. Continuous OPLL was seen in the majority of patients (40/57). Posterior decompressive surgery was performed in 18 patients, a median corpectomy and excision of the OPLL in 28 and anterior segmental decompression in 11 patients. One patient had a transient weakness of muscles supplied by the C5 myotome following a C4-C5 corpectomy. 84.2% of the patients showed improvement by at least one grade at the time of discharge. 92.8% of patients who underwent a corpectomy improved in the immediate post-operative period as compared to 90.9% of those who underwent an anterior segmental decompression and 83.3% of those who underwent a posterior decompressive procedure. 97.7% of the 44 patients followed-up between one and five years showed neurological improvement. Thirty-two patients (72.7 %) had regained normal or near normal neurological function and returned to their jobs. Good results were obtained when the surgical approach and the procedure adopted were individualised.