Influence of Surgery on Postoperative Extension of Ossified Area in Ossification of the Posterior Longitudinal Ligament of the Cervical Spine : Radiological Study

Postoperative extension of the ossified area in ossification of the posterior longitudinal ligament (OPLL) of the cervical spine was studied in 76cases, who were surgically treated at the Dept. of Orthopedic Surgery, Yamaguchi University Hospital, with anaverage of 4 years follow-up. Forty-eight cases (63 per cent) were found to have postoperative extension of the ossification. Out of 18 cases with anterior approach, 10 (56 per cent) experienced postoperative ossification, as did 18 (69 per cent) of 26 with laminectomy, and 20 (63 per cent) of 32 with enlargement of the spinal canal. The stimulus of the surgical intervention itself was not observed to have any direct effect on ossification. Six months after surgery, about 13 per cent of the cases was found to have extension of the ossification probably caused by postoperative biomechanical changes of the cervical spine due to either structural changes of the spine or movable changes of the intervertebral spaces. Fifty per cent of the cases may have been operated on during the increasing period of the ossification. Therefore, it can be concluded that there seems to be no relationship between the surgery and the extension of ossification.

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