Multilevel Anterior Cervical Corpectomy and Fusion for Ossification of the Posterior Longitudinal Ligament

Background: Cervical ossification of the posterior longitudinal ligament (OPLL) is a kind of spinal disorder widely spared in Asia. In dealing with multilevel cervical OPLL, the ideal surgical approach is still under debate. Here we introduce our findings of multilevel anterior cervical corpectomy and fusion (ACCF) in treating multilevel cervical OPLLMethods 79 patients with multilevel cervical OPLL who had ACOR on C4-C5 or C5-C6 were retrospectively reviewed. Patients’ Japanese Orthopedic Association (JOA) Score, the improvement rate of JOA Scores (RIS), sagittal cervical mobility (SCM) and the distance between the lower endplate of the vertebra body above the titanium mesh and the superior endplate of the vertebra body below the titanium mesh ( L ) were analyzed and subjected into paired-t test. Radiographic features and complications were described as well.Results p<0.001 in all paired-t tests of JOA Scores, SCM and L at 1day, 6months, 1year and 2year follow-ups compared with preoperative ones. Patients’ RIS continued to increase in 2 years. 6 (7.59%) patients’ L at the 2 years follow-up shortened more than 10mm than their postoperative L. 1 (1.27%) patient had severe titanium mesh canting.Conclusions Multilevel ACCF procedure has positive outcomes in treating multilevel cervical OPLL. Postoperative complications like titanium subsidence and dislocation can happen after this procedure. Follow-ups should be conducted regularly and thoroughly with this kind of patients.