Anterior corpectomy and fusion for cervical ossification of posterior longitudinal ligament associated with developmental canal stenosis

Objective: The aim of this study was first to evaluate the safety and efficacy of anterior corpectomy and fusion (ACF) for cervical ossification of the posterior longitudinal ligament (OPLL) associated with developmental canal stenosis. Methods: Between May 2007 and May 2010, twenty-two patients with cervical myelopathy underwent ACF and all patients showed OPLL and developmental canal stenosis. A retrospective review of clinical and radiological data before and after surgery was conducted. Results: There were 17 men and 5 women with mean age of 57.3 years and a mean follow-up period of 25.5 months. The average Japanese Orthopedic Association (JOA) score before surgery was 8.5 points which significantly increased to 14.1 points at the last follow-up (P<0.05). The improvement rate of the JOA score ranged from 20.0% to 87.5%, with a mean of 67.0%±17.1%. The excellent and good clinical results according to Hirabayashi’s criteria were obtained in 19 patients (86.4%) at the last follow-up. The average cord flattening rate improved from 25% to 51% and the average Cobb’s angle increased from 6.3 degrees to 12.5 degrees at the last follow-up (P<0.05). There were no severe surgical complications, including failure of fusion. Conclusion: Our study results demonstrate that oneor two-level anterior corpectomy and fusion is applicable as a surgical treatment of cervical OPLL even where developmental canal stenosis is present.