ANTERIOR DECOMPRESSION AND FUSION USING BONE-GRAFTS OBTAINED FROM CERVICAL VERTEBRAL BODIES FOR OSSIFICATION OF THE POSTERIOR LONGITUDINAL LIGAMENT OF THE CERVICAL-SPINE - TECHNICAL NOTE

OBJECTIVE: To describe a surgical technique of anterior decompression and fusion using bone grafts obtained from cervical vertebral bodies w ith ossification of the posterior longitudinal ligament of the cervica l spine. This technique seeks to avoid complications associated with a n anterior approach of decompression and bone fusion, which widely use s autogenous bone from the iliac crest. METHODS: Forty patients with c ervical myelopathy were studied. The ossified ligament was localized t o one, two, three, four, five, six, and seven vertebral bodies in 10, 18, 5, 4, 1, 1, and 1 patients, respectively. The ossified area of all posterior longitudinal ligament was completely removed using microsur gical techniques, and 11 patients were operated on at one level, 21 at two levels, and 8 at three levels. RESULTS: The symptoms of all patie nts improved after the operation. Post-operative x-ray films showed so lid bone fusion in all patients at a mean follow-up time of 3 years (r ange, 1-5.25 yr). Anterior angulation was found in one of eight patien ts (13%) who underwent three-level fusion. CONCLUSION: Two major advan tages were as follows: 1) no complications related to the iliac donor site occurred, and 2) early mobilization of patients was possible with a soft cervical collar. Anterior decompression and fusion should be u sed for cases with ossification of up to three consecutive vertebrae n eeding either one- or two-level fusions.