Does Anterior Controllable Antidisplacement and Fusion Technique Improve Quality of Life in Revision Treatment for Cervical Ossification of the Posterior Longitudinal Ligament? Three-Year Follow-Up Study

Abstract

\n Background: The laminoplasty and laminectomy are two comparatively safe posterior procedures for the treatment of OPLL. The long-term outcomes of posterior surgery seem to be favorable, however it is also criticized for C5 nerve root palsy, progression OPLL and bad cervical lordosis. An additional revision surgery was required for those patients who had the poor clinical improvement after the initial posterior surgery.Methods: This study was to identify the mid-term clinical results and the health-related quality of life (HRQoL) after anterior controllable antidisplacement and fusion (ACAF) technique for revision treatment of cervical ossification of the posterior longitudinal ligament (OPLL). All the patients were followed up for more than 3 years. The Japanese Orthopaedic Association (JOA) scales, Neck Disability Index (NDI) and Short-Form 36 (SF-36) were recorded to evaluate the health-related quality of life. And the neck and arm pain scale as an expression of visual analog scale (VAS) were also collected. Intraoperative parameters, clinical features, radiological investigations and the surgery-related complications were performed to analysis. Results: There were 20 patients who underwent ACAF revision surgery between March 2017 and January 2019. Clinical improvements were observed in all outcomes; significant improvements on the NDI, VAS, SF-36, and JOA scores were maintained at 3 years (P < 0.05). All the patients showed a better cervical alignment, and the average cervical lordosis was 17±4.6° after revision surgery. There was only one case of cerebrospinal fluid (CSF) leakage, no instance of C5 root platy, postoperative hematoma or esophageal injury occured. No instrumented failure or pseudarthrosis case was observed during the follow-up.Conclusions: This study suggested that ACAF is an effective and safe procedure for the revision treatment of cervical OPLL. Such a surgical technique can offer the postoperative improvement on pain levels and health-related quality of life.