Progression of Ossification of the Posterior Longitudinal Ligament after Cervical Total Disc Replacement

Ham, Jeong Sik; Kim, Jang Hun; Yoon, Joon; Hwang, Sung Hwan; Yoon, San-Hyun

doi:10.13004/kjnt.2019.15.e28

Cited by 6 publications

(10 citation statements)

References 16 publications

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“…The frequent manifestation of OPLL without signs of degenerative disc disease supports additional biomechanical processes in IVDD. The progression of OPLL occurred more frequently at the levels of total disc replacement than at those of fusion, suggesting that the growth of the ossified mass can occur without the influence of IVDD (38). In contrast, other researchers suggest prolapse of the nucleus pulposus to be an initiating stimulus for OPLL (39).…”

Section: Discussionmentioning

confidence: 96%

Analysis of intervertebral disc degeneration in patients with ossification of the posterior longitudinal ligament

Luo¹,

Sun²,

Zhu³

et al. 2022

Quant Imaging Med Surg

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Background: As degenerative disease with nerve compression, little is known about the relationship between cervical ossification of the posterior longitudinal ligament (OPLL) and intervertebral disc degeneration (IVDD). This study investigates the effect of ossification of ligaments on IVDD in patients with cervical OPLL. We focus on the ossification-related segment in patients diagnosed with OPLL, which is characterized by ossification that crosses intervertebral space or occurs concurrently in the upper and lower vertebrae.Methods: A total of 92 ossification-related segments from 40 patients were involved in the study. X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) were used to evaluate the ossification thickness, disc height, cervical range of motion (ROM) of the segment, Kang's grade, and disc signal loss.We conducted correlation analysis and subgroup comparisons to analyze the type of ossification, ossification thickness, disc height, disc signal loss, ROM and Kang's grade. Results:The specific ossification thickness was negatively correlated with the disc signal loss (P<0.05). Specific ossification thickness and specific disc height were positively correlated (P<0.05). Segments were divided into the nude group (ossification not crossing the intervertebral space) and the covered group (ossification crossing the intervertebral space). The nude group presented smaller ossification thickness and disc height, and a higher grade of disc signal loss and ROM (P<0.05). Conclusions:The formation of OPLL may be interrelated with the alleviation of IVDD at the same segment. Furthermore, IVDD is not only related to the limited ROM caused by ossification, but also the size and shape of the ossified mass. A negative correlation exists between the ossification thickness and the severity of IVDD in OPLL patients. Ossification that crosses the interverbal space is associated with lower ROM, a thicker ossified mass, and better disc signal. For patients with nude ossification-related segments, a fusion surgery to restore intervertebral stabilization deserves serious consideration.

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Section: Discussionmentioning

confidence: 96%

Analysis of intervertebral disc degeneration in patients with ossification of the posterior longitudinal ligament

Luo¹,

Sun²,

Zhu³

et al. 2022

Quant Imaging Med Surg

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“…84 Since persistent motion is thought to lead to the progression of OPLL, this particular condition has historically been considered a relative contraindication to a motion-preserving CDA. 85 Riew et al 78 reported on the safety of CDA from the Prestige ST and Bryan IDE studies for myelopathy but specifically commented that their study did not evaluate the treatment of compression secondary to OPLL.…”

Section: Cda For Cervical Myelopathy Congenital Cervical Stenosis And...mentioning

confidence: 99%

Current and Expanded Indications for Cervical Disc Arthroplasty

Divi,

Plantz,

Tegethoff

et al. 2023

Clinical Spine Surgery: A Spine Publication

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The widespread success of cervical disc arthroplasty (CDA) has led to an interest in expanding indications beyond those outlined in the initial Food and Drug Administration investigational device exemption studies. Some of these off-label indications currently include 3-level and 4-level CDA, hybrid constructs with adjacent segment anterior cervical discectomy and fusion or corpectomy constructs, pre-existing kyphosis, revision of a failed anterior cervical discectomy and fusion to a CDA, CDA in the setting of significant degenerative disc disease and/or facet joint arthropathy, CDA for congenital cervical stenosis, and CDA in the presence of ossification of the posterior longitudinal ligament. This review article will summarize the current literature pertaining to the aforementioned indications.

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“…Numerous studies have reported on OPLL progression and established risk factors for progression, including types of OPLL, timing and location of OPLL progression, and type of surgeries [9][10][11][12][13][14][15][16][17][18]. When considering the impact of OPLL type on the progression of OPLL, it should be noted that OPLL type could change during the follow-up period [10][11][12]. Chiba et al reported a higher rate of postoperative OPLL progression in continuous-type and mixed-type OPLL [20].…”

Section: Case Reportmentioning

confidence: 99%

“…A variety of surgical approaches have been described utilizing anterior, posterior, and combined anteroposterior approaches, each with unique risks and benefits [5]. Many studies have reported on the pathogenesis of the progression of preexisting OPLL after cervical spine surgeries [6][7][8][9][10][11]. The rate of postoperative progression of OPLL is higher in posterior-approach surgeries than in anteriorapproach surgeries.…”

Section: Introductionmentioning

confidence: 99%

“…When considering only posteriorapproach surgeries, motion-preserving laminoplasty has shown a higher rate of OPLL progression than the laminectomy and fusion procedure [12][13][14][15][16][17][18]. There are very few reports on progression of OPLL after anterior cervical spine surgeries [9,11]. To our knowledge, however, new development and progression of ossification of posterior longitudinal ligament (OPLL) after cervical disc arthroplasty (CDA) have not been reported.…”

Section: Introductionmentioning

confidence: 99%

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New Development and Progression of Ossification of the Posterior Longitudinal Ligament (OPLL) after Cervical Disc Arthroplasty: A Case Report

Park¹

2022

bbj

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Purpose: To report an extremely rare case of new development and progression of ossification of posterior longitudinal ligament (OPLL) after cervical disc arthroplasty (CDA). Background: To our knowledge, new development and progression of ossification of OPLL after CDA have not been reported. Methods: A 44-year-old female with cervical disc herniation at C5-6 presented with radiculopathy. The patient had no evidence of preexisting OPLL on plain radiographs and magnetic resonance imaging. She underwent CDR at C5-6 and her symptoms were significantly improved after surgery. Results: New development of OPLL at C5-7-T1 was identified for the first time at 6 years after CDA at C5-6, and progression of OPLL was observed at 3 & 13 years’ follow-up. Due to new development and progression of OPLL, there was no segmental motion at C5-6 with CDA. The patient continued to follow up without further surgery because there was no deterioration in clinical symptoms. Conclusion: Our study demonstrated an extremely rare case of new development and progression of OPLL after CDA with a long term follow-up. Our case suggests potential clues for discovering the complex pathological mechanism of OPLL. Keywords: Ossification of the posterior longitudinal ligament, New development, Progression, Cervical disc arthroplasty

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Progression of Ossification of the Posterior Longitudinal Ligament after Cervical Total Disc Replacement

Cited by 6 publications

References 16 publications

Analysis of intervertebral disc degeneration in patients with ossification of the posterior longitudinal ligament

Analysis of intervertebral disc degeneration in patients with ossification of the posterior longitudinal ligament

Current and Expanded Indications for Cervical Disc Arthroplasty

New Development and Progression of Ossification of the Posterior Longitudinal Ligament (OPLL) after Cervical Disc Arthroplasty: A Case Report

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