Surgical decision-making for ossification of the posterior longitudinal ligament versus other types of degenerative cervical myelopathy: anterior versus posterior approaches

Abstract

Abstract Background The debate between anterior or posterior approach for pathologies such as cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) have drawn heated debate but are still inconclusive. Main body of the abstract A narrative review was performed specifically to study the differences pertaining to OPLL and other causes of degenerative cervical myelopathy (DCM). Current evidence suggests that anterior approach is preferred for K-line (−) OPLL, K-line (+) with canal occupying ratio > 60% and DCM with pre-existing cervical kyphosis. Posterior approach is preferred for K-line (+) OPLL with canal-occupying ratio 60% for OPLL patients. Posterior approach is considered for patients with multi-level pathology for DCM, and K-line (+) and canal-occupying ratio < 50–60% for OPLL.

Keywords

• Cervical myelopathy
• Ossification of the posterior longitudinal ligament
• OPLL
• Cervical spine
• Degenerative cervical myelopathy
• DCM