THE SURGICAL-MANAGEMENT OF OSSIFICATION OF THE POSTERIOR LONGITUDINALLIGAMENT IN 51 PATIENTS

Ossification of the posterior longitudinal ligament (OPLL) in the cerv ical spine warrants unique clinical, radiographic, and surgical manage ment. OPLL patients presenting with severe myelopathy require full ass essment with both magnetic resonance imaging (MRI) and computed tomogr aphy-based (noncontrast CT, myelo-CT, three-dimensional CT) examinatio ns to document the full extent of their disease. Whether better surgic al outcomes are attained after anterior resection (diskectomy/corpecto my), rather than posterior decompression (laminectomy/ laminoplasty) o f OPLL remains controversial. However, our recent experience with 51 O PLL patients indicates superior results after anterior (41 patients) v ersus posterior (10 patients) surgery. Continuous intraoperative somat osensory evoked potential (SSEP) monitoring also appears to limit oper ative morbidity.