Segmental anterior decompression and fusion for multilevel ossification of the posterior longitudinal ligament

The purpose of this study was to evaluate the outcome of segmental anterior decompression and fusion for multilevel ossification of the posterior longitudinal ligament. Data were collected from 23 patients with multilevel ossification of the posterior longitudinal ligament. Average operative time and blood loss were 121 minutes and 201.6 mL, respectively. The Nurick score significantly decreased from 2.7±0.9 preoperatively to 1.8±0.9 at last follow-up (P<.01). The preoperative Japanese Orthopaedic Association score was 8.2, which significantly increased to 13.8 points at last follow-up (P<.01), with an improvement rate of 64.5%. The operation also significantly increased cervical lordosis (P<.01) from 7.7° preoperatively to 13.3° postoperatively. The fusion rate was 95.7% at 6 months postoperatively, and 100% at 12 months postoperatively. The loss of cervical lordosis and height of fusion segments were 1.2° and 0.9 mm at last follow-up, respectively. No hardware complications occurred. Cerebrospinal fluid leakage occurred in 2 patients, and hematoma occurred in 1 patient who needed an emergency operation. Segmental anterior decompression and fusion was generally effective and safe in the treatment of multilevel ossification of the posterior longitudinal ligament if indications were well controlled.