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- Publisher Website: 10.1186/s12891-020-03830-0
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Article: Surgical decision-making for ossification of the posterior longitudinal ligament versus other types of degenerative cervical myelopathy: anterior versus posterior approaches
Title | Surgical decision-making for ossification of the posterior longitudinal ligament versus other types of degenerative cervical myelopathy: anterior versus posterior approaches |
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Authors | |
Keywords | Cervical myelopathy Ossification of the posterior longitudinal ligament OPLL Cervical spine Degenerative cervical myelopathy |
Issue Date | 2020 |
Publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmusculoskeletdisord/ |
Citation | BMC Musculoskeletal Disorders, 2020, v. 21, p. article no. 823 How to Cite? |
Abstract | Background:
The debate between anterior or posterior approach for pathologies such as cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) have drawn heated debate but are still inconclusive.
Main body of the abstract:
A narrative review was performed specifically to study the differences pertaining to OPLL and other causes of degenerative cervical myelopathy (DCM). Current evidence suggests that anterior approach is preferred for K-line (−) OPLL, K-line (+) with canal occupying ratio > 60% and DCM with pre-existing cervical kyphosis. Posterior approach is preferred for K-line (+) OPLL with canal-occupying ratio < 50–60%, and multi-level CSM. No particular advantage for either approach was observed for DCM in a lordotic cervical spine. Anterior approach is generally associated with more complications and thus needs to be weighed carefully during decision-making. The evidence is not convincing for comparing single versus multi-level involvement, and the role of patients' co-morbidity status, pre-existing osteoporosis and co-existent spinal pathologies in influencing patient outcome and surgical options. This should be a platform for future research directives.
Conclusion:
From this review, evidence is still inconclusive but there are some factors to consider, and DCM and OPLL should be considered separately for decision-making. Anterior approach is considered for pre-existing cervical kyphosis in DCM, for K-line (−) regardless of canal-occupying ratio, and K-line (+) and canal-occupying ratio > 60% for OPLL patients. Posterior approach is considered for patients with multi-level pathology for DCM, and K-line (+) and canal-occupying ratio < 50–60% for OPLL. |
Persistent Identifier | http://hdl.handle.net/10722/295267 |
ISSN | 2023 Impact Factor: 2.2 2023 SCImago Journal Rankings: 0.714 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Kwok, SSS | - |
dc.contributor.author | Cheung, JPY | - |
dc.date.accessioned | 2021-01-11T13:57:42Z | - |
dc.date.available | 2021-01-11T13:57:42Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | BMC Musculoskeletal Disorders, 2020, v. 21, p. article no. 823 | - |
dc.identifier.issn | 1471-2474 | - |
dc.identifier.uri | http://hdl.handle.net/10722/295267 | - |
dc.description.abstract | Background: The debate between anterior or posterior approach for pathologies such as cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) have drawn heated debate but are still inconclusive. Main body of the abstract: A narrative review was performed specifically to study the differences pertaining to OPLL and other causes of degenerative cervical myelopathy (DCM). Current evidence suggests that anterior approach is preferred for K-line (−) OPLL, K-line (+) with canal occupying ratio > 60% and DCM with pre-existing cervical kyphosis. Posterior approach is preferred for K-line (+) OPLL with canal-occupying ratio < 50–60%, and multi-level CSM. No particular advantage for either approach was observed for DCM in a lordotic cervical spine. Anterior approach is generally associated with more complications and thus needs to be weighed carefully during decision-making. The evidence is not convincing for comparing single versus multi-level involvement, and the role of patients' co-morbidity status, pre-existing osteoporosis and co-existent spinal pathologies in influencing patient outcome and surgical options. This should be a platform for future research directives. Conclusion: From this review, evidence is still inconclusive but there are some factors to consider, and DCM and OPLL should be considered separately for decision-making. Anterior approach is considered for pre-existing cervical kyphosis in DCM, for K-line (−) regardless of canal-occupying ratio, and K-line (+) and canal-occupying ratio > 60% for OPLL patients. Posterior approach is considered for patients with multi-level pathology for DCM, and K-line (+) and canal-occupying ratio < 50–60% for OPLL. | - |
dc.language | eng | - |
dc.publisher | BioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmusculoskeletdisord/ | - |
dc.relation.ispartof | BMC Musculoskeletal Disorders | - |
dc.rights | BMC Musculoskeletal Disorders. Copyright © BioMed Central Ltd. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Cervical myelopathy | - |
dc.subject | Ossification of the posterior longitudinal ligament | - |
dc.subject | OPLL | - |
dc.subject | Cervical spine | - |
dc.subject | Degenerative cervical myelopathy | - |
dc.title | Surgical decision-making for ossification of the posterior longitudinal ligament versus other types of degenerative cervical myelopathy: anterior versus posterior approaches | - |
dc.type | Article | - |
dc.identifier.email | Cheung, JPY: cheungjp@hku.hk | - |
dc.identifier.authority | Cheung, JPY=rp01685 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1186/s12891-020-03830-0 | - |
dc.identifier.pmid | 33292175 | - |
dc.identifier.pmcid | PMC7724709 | - |
dc.identifier.scopus | eid_2-s2.0-85097260900 | - |
dc.identifier.hkuros | 320896 | - |
dc.identifier.volume | 21 | - |
dc.identifier.spage | article no. 823 | - |
dc.identifier.epage | article no. 823 | - |
dc.identifier.isi | WOS:000600126500001 | - |
dc.publisher.place | United Kingdom | - |