Anterior controllable antedisplacement and fusion as revision surgery for the treatment of OPLL after anterior and posterior decompression: A case report
Abstract
Background: In cases of cervical ossification of the posterior longitudinal ligament (OPLL), when initial anterior or posterior decompression fails to yield satisfactory results, the alternative approach is often chosen for revision surgery. Nevertheless, there is a lack of reported information regarding the treatment and prognosis of patients with complex OPLL who have undergone both anterior and posterior decompression but experienced relapse.
Case presentation: A 79-year-old male patient presented with numbness, weakness, and muscle atrophy in the right upper extremity, along with weakness in the right lower extremity. Initial assessment on admission revealed a Japanese Orthopaedic Association (JOA) score of 7. The patient previously underwent anterior cervical discectomy and fusion (ACDF) 25 years ago for spinal stenosis, followed by posterior laminectomy as revision surgery. After experiencing recurrent symptoms following a fall one year ago, the patient underwent a second revision surgery using the anterior controllable antedisplacement and fusion (ACAF) technique which led to symptom improvement, and resulted in a postoperative JOA score of 14 at 3 months of follow-up.
Conclusions: Treatment of OPLL patients with symptom recurrence after traditional anterior and posterior decompression is challenging. ACAF offers a viable solution for managing this complex case.
References
- Youssef JA, Heiner AD, Montgomery JR, Tender GC, Lorio MP, Morreale JM, Phillips FM. (2019). Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis. Spine Journal, 19(10), 1714-1729. DOI: 10.1016/j.spinee.2019.04.019
- Le HV, Wick JB, Van BW, Klineberg EO. Ossification of the Posterior Longitudinal Ligament: Pathophysiology, Diagnosis, and Management. J Am Acad Orthop Surg. 2022 Sep 1;30(17):820-830. doi: 10.5435/JAAOS-D-22-00049.
- Zileli M, Akıntürk N. (2021). Commentary: Microsurgical Anterior Controllable Antedisplacement Fusion to Treat Cervical Ossified Posterior Longitudinal Ligament: 2-Dimensional Operative Video. Operative Neurosurgery (Hagerstown), 20(3), E222-E224. DOI: 10.1093/ons/opaa439
- Sun J, Shi J, Xu X, Yang Y, Wang Y, Kong Q, Yang H, Guo Y, Han D, Jiang J, Shi G, Yuan W, Jia L. (2018). Anterior controllable antidisplacement and fusion surgery for the treatment of multilevel severe ossification of the posterior longitudinal ligament with myelopathy: preliminary clinical results of a novel technique. European Spine Journal, 27(6), 1469-1478. DOI: 10.1007/s00586-017-5437-4
- Chen Y, Sun J, Yuan X, Guo Y, Yang H, Chen D, Shi J. (2020). Comparison of Anterior Controllable Antedisplacement and Fusion With Posterior Laminoplasty in the Treatment of Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective, Randomized, and Control Study With at Least 1-Year Follow Up. Spine, 45(16), 1091-1101. DOI: 10.1097/BRS.0000000000003462
- Duan W, Chou D, Jian F, Chen Z. Microsurgical Anterior Controllable Antedisplacement Fusion to Treat Cervical Ossified Posterior Longitudinal Ligament: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown). 2021 Feb 16;20(3): E221. DOI: 10.1093/ons/opaa376.
- Lee, D.-H., Park, S., & Hong, C. G. (2020). A novel anterior decompression technique for kyphosis line (K-line) ossification of posterior longitudinal ligament (OPLL): vertebral body sliding osteotomy. Journal of Spine Surgery, 6(1), 196-204. DOI: 10.21037/jss.2019.12.05.
- Sun, J., Shi, J., Xu, X., Yang, Y., Wang, Y., et al. (2018). Anterior controllable antidisplacement and fusion surgery for the treatment of multilevel severe ossification of the posterior longitudinal ligament with myelopathy: preliminary clinical results of a novel technique. European Spine Journal, 27(6), 1469-1478. DOI: 10.1007/s00586-017-5437-4.
- Wang, H., Sun, J., Tan Y., Li P., Xu M., et al. (2019). Anterior Controllable Antedisplacement and Fusion as Revision Surgery After Posterior Decompression Surgery in Patients with Ossification of the Posterior Longitudinal Ligament. World Neurosurgery, Mar:123: e310-e317. DOI: 10.1007/s00586-017-5437-4.
- Yu, C., Sun, J., Yuan, X., Guo, Y., Yang, H., et al. (2020). Comparison of anterior controllable antedisplacement and fusion with posterior laminoplasty in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a prospective, randomized, and control study with at least 1-year follow up. Spine, 45(16):1091-1101. DOI: 10.1007/s00586-017-5437-4.
How to Cite
Funding data
-
Beijing Municipal Administration of Hospitals
Grant numbers QML20210801
Downloads
Article Details
Most Read This Month
License
Copyright (c) 2023 Tianyu Jin, Wanru Duan, Zan Chen
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
