Removal of posterior longitudinal ligament may be beneficial during anterior decompression
Findings from a recently published study showed the removal of a degenerative posterior longitudinal ligament can be beneficial during anterior decompression procedures.
Researchers retrospectively reviewed clinical data for 130 patients with confirmed degenerative posterior longitudinal ligament who underwent anterior cervical decompression procedures. The ligament was removed in 62 patients and retained in 68 patients, and patients were followed for 36 months.
Patient outcomes in the study led researchers to conclude that patients with the removed ligament had better decompression and better postoperative outcomes when compared with patients with an intact ligament. Japanese Orthopedic Association score improved from 9 to 14.7 in patients with the removed ligament, compared with an improvement from 9.4 to 14.1 in patients with an intact ligament.
Data analysis showed the recovery rate for spinal cord neurologic function of patients with a removed ligament was significantly greater than in patients with an intact ligament (66.7% vs. 61.3%).
MRI scans showed the median sagittal diameter of the operating cervical vertebral canal enlarged more significantly in the patients without a ligament, from 7.1 mm to 11.6 mm, compared with 7.8 mm to 10.4 mm in patients with an intact ligament, according to the researchers.
Both groups had similar rates of common complications.
The researchers concluded that although the operation was safe, it required longer operating times, was more technically challenging and required the surgeon to be more experienced than surgery where the ligament was left intact. – by Robert Linnehan
Disclosure: The authors have no relevant financial disclosures.