Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

• DOI: 10.14245/ns.1938222.111
• Publication Date: 2019-09-26T22:03:18Z
• Authors: Jeffery Head; George Rymarczuk; Geoffrey Stricsek; Lohit Velagapudi; Christopher Maulucci; Christian Hoelscher; James Harrop
• Keywords: Cerebrospinal fluid leak; Posterior longitudinal ligament

Ossification of the posterior longitudinal ligament (OPLL) is a rare but potentially devastating cause degenerative cervical myelopathy (DCM). Decompressive surgery standard care for OPLL and can be achieved through anterior, posterior, or combined approaches to spine. Surgical correction via any approach associated with higher rates complications presence considered significant risk factor perioperative in DCM surgeries. Potential include dural tear (DT) subsequent cerebrospinal fluid leak, C5 palsy, hematoma, hardware failure, surgical site infections, other neurological deficits. Anterior are technically more demanding DT offer greater access ventral pathology. Posterior lower may allow continued disease progression. Therefore, decision pursue either an anterior decompression critically influenced by each procedure. The authors review particular focus on approach. We also recent work developing new treatments that aim reduce complication incidence.