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Journal of Korean Neurosurgical Society 1988;17(6): 1413-1420.
The Surgical Treatment of Cervical OPLL.
S W Choi, H K Rha, G S Lee, M S Ahn, C R Choi, J U Song
Department of Neurosurgery, St. Paul's Hospital Catholic Medical College, Seoul, Korea.
We have operated on 40 patients with radiculopathy and myelopathy with cervical ossification of posterior longitudinal ligament(OPLL) within recent 4 years. The age of patient at operation was from 4th decade to 8th decade, with the largest numer in the 6th decade. Three times more men than women were affected. The surgical technique was selected in most cases on the basis of radiological findings. 26 patients underwent anterior approach by transuncal discal approach(TUD) and vertebrotomy. 14 patients underwent posterior approach by laminectomy and widening laminoplasty. Outcome of operation was generally good. Of 40 patients, 32 cases were in the excellent or good results. A short duration of symptoms before operation was associated with better results, but there not influenced by the age of the patients. In selection of operative method, we suggest that 1)Anterior approach is a better method in case of the patient whose lesion is limited at one of two levels without any narrow spinal canal, 2) In case having a lesion more than two levels and especially accompaning multiple canal stenosis, posterior approach may be effective, and widening laminoplasty is a better method than extensive laminectomy which could be complicated with postoperative spinal instability, scar formation at operation area, and abnormal curvature of the cervical spine.
Key Words: Radiculopathy myelopathy; OPLL; Anterior approach; Extensive laminectomy; Widening laminoplasty
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