Comparing effects of cervical anterior approach and laminoplasty in surgical management of cervical ossification of posterior longitudinal ligament by a prospective nonrandomized controlled study

Abstract Introduction The laminoplasty has been the most widely used surgical method for OPLL. In recent years, increasing attention has been drawn to the anterior operative approaches for surgical treatment of cervical OPLL. However, which method is the optimum selection for therapy of cervical OPLL is still obscure. Therefore, we performed this prospective nonrandomized clinical studyin patients with multilevelcervical myelopathydue to OPLL and compare thetherapeutic efficiencyof laminoplastyand anterior approach (cervical discectomy and/or cervicalcorpectomy) in the management of multi-level cervical OPLL. Hypothesis There is no difference in clinical effects between anterior cervical spine surgery and laminoplastyin treatment of multi-level cervicalOPLL Materialandmethods A total of 150 consecutive patients with multi-levels of cervical OPLL underwent anterior approaches (ACDF, ACCF and HDF) fromJuly2010 to June 2014, which were enrolled in this study. During the same period, one hundred and two patients receiving the laminoplasty were enrolled in the study. The clinical effects, alignment and range of motion (ROM) of cervical spine in patients of the anterior group and posterior group were assessed, respectively. The effects of high signals in T2 weighed MRI scans and percentage of spinal canal stenosis in these patients were also evaluated. Finally, postoperativecomplications regardingeach group were analyzed. Results Although significant differences in types of OPLL and preoperative sagittal alignment of cervical spine occurred in the two groups ( P 0.05). The cervical curvature in laminoplasty group showed significant decrease at final follow-up ( P