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Vertebral body sliding technique for OPLL may be safer than traditional treatment

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ORLANDO, Fla. – A vertebral sliding technique can safely help expand a stenotic spinal canal in patients with ossification of the posterior longitudinal ligament or OPLL, based on results of a study.

At the Cervical Spine Research Society Annual Meeting, here, Dong-Ho Lee, MD, PhD, of Seoul, Korea, presented the findings of a study of patients who underwent anterior decompression of severe OPLL using a vertebral sliding technique. According to Lee, the technique may be safer and more efficient compared to the more traditional approach of anterior decompression and fusion.

“The vertebral body sliding technique shifts the involved vertebral body and ossified mass anteriorly, and expanded the spinal canal safely and efficiently. Since surgeons do not need to directly manipulate the OPLL mass or dissect the interspace between the OPLL and dura, it may be a safer procedure in patients, especially with a higher canal occupying ratio or a high likelihood of a dural adhesion,” Lee said.

Lee reported on 12 patients with OPLL who were treated with this technique and followed for at least 1 year. Study results showed the mean occupying canal ratio was decreased from 56% to 15% and the Japanese Orthopaedic Association (JOA) scores significantly improved.

The JOA recovery rate was 76.9%, Lee said.

The mean canal encroachment at the involved segments was 5.4 mm preoperatively, which significantly improved to 2.4 mm after surgery, he said.

“Mean operative time was 245 minutes, however it tends to shorten gradually with experience. Mean blood loss was 352 cc, which also decreases as we accumulate experience. Although one patient showed radiographic pseudarthrosis without neurologic symptoms at postop for 1year, we have not experienced any neurologic deteriorations, CSF (cerebrospinal fluid) leakage or graft-related complications,” Lee said. – by Robert Linnehan

Reference:

Lee DH. Paper #16. Presented at: Cervical Spine Research Society Annual Meeting; Dec. 4-6, 2014; Orlando, Fla.

Disclosure: Lee has no relevant financial disclosures.