Percutaneous Fully-endoscopic Anterior Transcorporeal Procedure for the Treatment of Isolated Ossification of the Posterior Longitudinal Ligament in the Cervical Spine: A Case Report
Jin Li, Jun Ao, Xiaolin Hu, Qian Du, Jianpu Qin, Wen Jun Ji, Zhijun Xin, Wenbo Liao
Percutaneous Fully-endoscopic Anterior Transcorporeal Procedure for the Treatment of Isolated Ossification of the Posterior Longitudinal Ligament in the Cervical Spine: A Case Report
Background:: With the development of spinal endoscopic techniques, on the basis of our previous experience in treating various types of cervical disc herniation with this endoscopic technique, we took the lead in applying the percutaneous fully endoscopic anterior transcorporeal procedure to be utilized in the treatment of the isolated cervical ossification of the posterior longitudinal ligament (OPLL).
Case Presentation:: A 66-year-old male patient who weighed 57 kg, with a height of 169 cm was admitted to the hospital on September 16, 2021 because of recurrent pain and numbness in the neck, shoulder, and right arm for 2 years, which as aggravated for the last 2 weeks. Two years ago, the patient developed neck and shoulder pain accompanied by right arm pain without obvious predisposing factors, and numbness in the first web space of the right hand. In the last 2 weeks, he had difficulty moving the right arm, but no pain or numbness in the contralateral arm. MRI and CT scans demonstrated that the ossified posterior longitudinal ligament of the cervical 5/6 vertebrae with spinal canal stenosis and seriously compressed the spinal cord patient was treated with a percutaneous fully endoscopic anterior transcorporeal procedure.
Conclusion:: Our percutaneous fully endoscopic anterior transcorporeal procedure is a feasible, minimally invasive surgery for treating isolated ossification of the posterior longitudinal ligament in the cervical spine.
Cervical spine / Fully-endoscopic / Ossification of posterior longitudinal ligament / Transcorporeal procedure
[1] |
Boody BS, Lendner M, Vaccaro AR. Ossification of the posterior longitudinal ligament in the cervical spine: a review. Int Orthop. 2019;43(4):797–805.
|
[2] |
Hirai T, Yoshii T, Ushio S, et al. A case report autopsy of compression of spinal cordowing to ossification with in spinal canal of the cervical spine. Arch JPN Chir. 1960;29:1003–1007.
|
[3] |
Hirai T, Yoshii T, Iwanami A, Takeuchi K, Mori K, Yamada T, et al. Prevalence and distribution of ossified lesions in the whole spine of patients with cervical ossification of the posterior longitudinal ligament a multicenter study (JOSL CT study). PloS One. 2016;11(8):e0160117.
|
[4] |
Le HV, Wick JB, Van BW, Klineberg EO. Ossification of the posterior longitudinal ligament: pathophysiology, diagnosis, and management. J Am Acad Orthop Surg. 2022;30(17):820–830.
|
[5] |
Zaveri GR, Jaiswal NP. A comparison of clinical and functional outcomes following anterior, posterior, and combined approaches for the management of cervical Spondylotic myelopathy. Indian J Orthop. 2019;53(4):493–501.
|
[6] |
Cao B, Chen J, Yuan B, Sun Y, Zhou S, Zhao Y, et al. Comparison of the outcome after anterior cervical ossified posterior longitudinal ligament en bloc resection versus posterior total laminectomy and fusion in patients with ossification of the cervical posterior longitudinal ligament: a prospective randomized controlled trial. Bone Joint J. 2023;105-B(4):412–421.
|
[7] |
MacDowall A, Löfgren H, Edström E, Brisby H, Parai C, Elmi-Terander A. Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial. Trials. 2023;24(1):106.
|
[8] |
Zhang JN, Hao DJ. Seesaw-like cervical ossification of posterior longitudinal ligament. World Neurosurg. 2021;150:127–131.
|
[9] |
Lee BJ, Lee S, Jeon SR, Roh SW, Park JH. A new indicator predicting the degree of cord shift after posterior decompression of cervical ossification of the posterior longitudinal ligament extended to the C2 level and its clinical usefulness. Turk Neurosurg. 2021;31(6):866–872.
|
[10] |
Miyazaki K, Kirita Y. Extensive simultaneous multisegment laminectomy for myelopathy due to the ossification of the posterior longitudinal ligament in the cervical region. Spine(Phila Pa 1976). 1986;11(6):531–542.
|
[11] |
Kim B, Yoon DH, Shin HC, Kim KN, Yi S, Shin DA, et al. Surgical outcome and prognostic factors of anterior decompression and fusion forcervical compressive myelopathy due to ossification of the posterior longitudinal ligament. Spine J. 2015;15(5):875–884.
|
[12] |
Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958 Jun;40-A(3):607–624.
|
[13] |
Yoshii T, Hirai T, Yamada T, Inose H, Kato T, Sakai K, et al. Intraoperative evaluation using mobile computed tomography in anterior cervical decompression with floating method for massive ossification of the posterior longitudinal ligament. J Orthop Surg Res. 2017;12(1):12.
|
[14] |
Kong QJ, Luo X, Tan Y, Sun JC, Wang Y, Tan L, et al. Anterior Controllable Antedisplacement and Fusion (ACAF) vs posterior Laminoplasty for multilevel severe cervical ossification of the posterior longitudinal ligament: retrospective study based on a two-year follow-up. Orthop Surg. 2021;13(2):474–483.
|
[15] |
Lee DH, Nam WD, Kim NY, Park JW, Hong CG. Fate of ossification of posterior longitudinal ligament following anterior cervical fusion: progression of cervical ossification of posterior longitudinal ligament after vertebral body sliding osteotomy or Laminoplasty. World Neurosurg. 2021;146:e1270–e1277.
|
[16] |
Chen H, Liu H, Deng Y, Gong Q, Li T, Song Y. Multivariate analysis of factors associated with axial symptoms in unilateral expansive open-door cervical Laminoplasty with Miniplate fixation. Medicine (Baltimore). 2016;95(2):e2292.
|
[17] |
Mori E, Ueta T, Maeda T, Yugué I, Kawano O, Shiba K. Effect of preservation of the C-6 spinous process and its paraspinal muscular attachment on the prevention of postoperative axial neck pain in C3-6 laminoplasty. J Neurosurg Spine. 2015;22(3):221–229.
|
[18] |
Yu S, Li F, Yan N, Yuan C, He S, Hou T. Anterior fusion technique for multilevel cervical spondylotic myelopathy: a retrospective analysis of surgical outcome of patients with different number of levels fused. PloS One. 2014;9(3):e91329.
|
[19] |
Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations. Int Orthop. 2009;33(6):1677–1682.
|
[20] |
Deng ZL, Chu L, Chen L, Yang JS. Anterior transcorporeal approach of percutaneous endoscopic cervical discectomy for disc herniation at the C4-C5 levels: a technical note. Spine J. 2016;16(5):659–666.
|
[21] |
Du Q, Wang X, Qin JP, et al. Percutaneous full-endoscopic anterior transcorporeal procedure for cervical disc herniation: a novel procedure and early follow-up study. World Neurosurg. 2018;112:e23–e30.
|
[22] |
Du Q, Lei LQ, Cao GR, et al. Percutaneous full-endoscopic anterior transcorporeal cervical discectomy and channel repair: a technique note report. BMC Musculoskelet Disord. 2019;20(1):280.
|
[23] |
Kong W, Xin Z, Du Q, Cao G, Liao W. Anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord for single-segment cervical spondylotic myelopathy: the technical interpretation and 2 years of clinical follow-up. J Orthop Surg Res. 2019;14(1):461.
|
[24] |
Qiao Y, Liao WB, Du Q, et al. Percutaneous full-endoscopic anterior Transcorporeal Diskectomy for massive migrated cervical disk herniation treatment: case report and review of the literature. World Neurosurg. 2019;132:47–52.
|
[25] |
Komotar RJ, Mocco J, Kaiser MG. Surgical management of cervical myelopathy: indications and techniques for laminectomy and fusion. Spine J. 2006;6(6 Suppl):252S–267S.
|
[26] |
Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976). 2007;32(21):2310–2317.
|
[27] |
Jagannathan J, Shaffrey CI, Oskouian RJ, Dumont AS, Herrold C, Sansur CA, et al. Radiographic and clinical outcomes following single-level anterior cervical discectomy and allograft fusion without plate placement or cervical collar. J Neurosurg Spine. 2008;8(5):420–428.
|
[28] |
Cerecedo-Lopez CD, Tafel I, Lak AM, Chi J, Lu Y, Groff M, et al. Surgical management of ossification of the posterior longitudinal ligament in the cervical spine. J Clin Neurosci. 2020;72:191–197.
|
[29] |
Kim JS, Eun SS, Prada N, Choi G, Lee SH. Modified transcorporeal anterior cervical microforaminotomy assisted by O-arm-based navigation: a technical case report. Eur Spine J. 2011;20(Suppl 2):S147–S152.
|
[30] |
Chu L, Yang JS, Yu KX, Chen CM, Hao DJ, Deng ZL. Usage of bone wax to facilitate percutaneous endoscopic cervical discectomy via anterior transcorporeal approach for cervical intervertebral disc herniation. World Neurosurg. 2018;118:102–108.
|
[31] |
Yu KX, Chu L, Yang JS, Deng R, Chen L, Shi L, et al. Anterior transcorporeal approach to percutaneous endoscopic cervical diskectomy for single-level cervical intervertebral disk herniation: case series with 2-year follow-up. World Neurosurg. 2019;122:e1345–e1353.
|
/
〈 | 〉 |