Decompression with or without Stabilisation in Cervical Ossification of the Posterior Longitudinal Ligament: A Case Series of Seven Cases
TL;DR
Both surgical strategies are effective; however, stabilisation offers better outcomes in cases with kyphosis, long-segment OPLL, or dynamic instability, so a tailored approach ensures optimal surgical results.
Abstract
Cervical Ossification of the Posterior Longitudinal Ligament (OPLL) is a common cause of cervical myelopathy requiring surgical intervention. Options include posterior decompression alone or decompression combined with stabilisation. Seven patients with radiologically proven cervical OPLL who underwent posterior cervical surgery were retrospectively reviewed. Three underwent decompression alone, and four underwent decompression with stabilisation. Neurological recovery was assessed using the modified Japanese Orthopaedic Association (mJOA) score. All patients showed postoperative neurological improvement. Patients undergoing decompression alone improved by 1-3 mJOA points, while those undergoing decompression with stabilisation, chosen for kyphosis, multi-segment OPLL, or instability, improved by 2-3 points. The mean improvement in mJOA score was 2.0 in the decompression group and 2.75 in the stabilisation group. Both surgical strategies are effective; however, stabilisation offers better outcomes in cases with kyphosis, long-segment OPLL, or dynamic instability. A tailored approach ensures optimal surgical results.