Yu Chen
The optimal approach for the treatment of ossification of the posterior longitudinal ligament (OPLL) in the cervical spine still remains controversial. Both anterior and posterior approaches have their advantages and disadvantages. We have developed a novel technique for this disease, called anterior controllable antidisplacement and fusion (ACAF). The study is to compare ACAF with laminoplasty in the treatment of multilevel OPLL, and evaluate the efficacy and safety of this procedure. Between September 2016 and April 2018, a total of 80 patients with multilevel OPLL were randomized in a 1:1 ratio to ACAF group and laminoplasty group. All patients were followed up at least one year. The results showed ACAF took a longer operation time. C5 palsy and axial pain occurred more commonly in laminoplasty group, whereas dysphagia and hoarseness appeared easily in ACAF group. At one-year follow-up, the final JOA score and RR were significant higher in ACAF group than those in laminoplasty group, when OR was not less than 60%, or K-line was negative. ACAF was also good at preservation of cervical lordosis and sagittal balance, but ROM of cervical spine in both groups decreased significantly. Therefore, ACAF is a safe and effective alternative for multilevel OPLL. Compared with laminoplasty, ACAF is more effective in the cases when OR is not less than 60%, or K-line is negative.
