IntroductionManaging patients who present with symptoms of cervical myelopathy secondary to cervical ossification of the posterior longitudinal ligament (OPLL) is challenging. Various factors such as the number of levels involved with OPLL, types of OPLL, canal occupying ratio, K-line characteristics, and C2-C7 lordosis angle were found to guide decision-making and surgical approaches in managing this condition. However, no clear treatment algorithm has been published. This study aims to investigate the outcome of the management of cervical OPLL using a treatment algorithm used in a tertiary university hospital. MethodsThis is a retrospective cross-sectional study. Patients with cervical myelopathy secondary to cervical OPLL who were treated surgically in our center from 2014 to 2020 were included in this study. Demographic data and preoperative parameters that determined the treatment given according to our treatment algorithm were analyzed. ResultA total of 24 patients fit the inclusion and exclusion criteria of the study. The mean recovery rate for all groups is 61.8 21.9% and the mean postoperative neck disability index (NDI) is 17.83 16.67%. There was a statistically significant difference between preoperative and postoperative Japanese Orthopaedic Association (JOA) scores for both anterior and posterior surgery subgroups. ConclusionWe believe that the treatment algorithm used in our center could benefit other surgeons as a guide in managing patients who suffer from cervical myelopathy secondary to cervical OPLL. Further study including newer techniques would increase the surgeon's arsenal in providing the best outcome in managing this condition.

The porous property of tantalum metal coupled with its high frictional surface and biocompatibility has made it an ideal biomaterial to facilitate bony fusion. This biomaterial is not unfamiliar to surgeons as it has been utilized with good clinical outcomes in arthroplasty. The usage of tantalum cages in spine surgery has gained traction. Complications resulting from the use of tantalum cage in lumbar fusion surgery were rarely reported. Here the authors would present a case of revision spinal surgery where the tantalum cage underwent migration from the previous posterior lumbar interbody fusion surgery. We further discuss ways to prevent such complications, precautions, tips, and tricks that could help other surgeons while dealing with this complication.

Patients with myelomeningocele associated with severe kyphoscoliosis usually presented with rigid and angulated gibbus at their back. The condition causes this group of patients to face difficulties in their daily activities, especially in sitting and lying in supine positions. They are also prone to have a pressure sore over the gibbus and encounter the risk of infection. Here the authors would present a case of a four-year-old girl with underlying myelomeningocele who was diagnosed with worsening kyphoscoliosis along her growth. Her whole spine x-ray radiograph revealed a kyphosis angle of 80° between the T11 and L4 levels. The patient underwent a deformity corrective surgery with total kyphectomy in a combination of anterior and posterior spinal instrumentation. In the present case, we were able to obtain sufficient correction of the spinal kyphotic deformity in that patient in a single-stage surgery with satisfactory surgical outcomes at a four years follow-up.