Abstract：
OBJECTIVE:The prevention and treatment of the common complication of cerebrospinal fluid leakage (CSFL) during anterior approach cervical spine surgery for severe ossification of the posterior longitudinal ligament (OPLL) is documented. METHOD:A retrospective analysis of 47 patients with severe cervical OPLL aged 39 to 73 years (average, 56.4 years) who underwent anterior operations was conducted. All patients were classified as local or segmental types based on the thickness of the ossified mass (>5 mm) and canal stenosis rates exceeding 50%. Fifteen cases underwent discectomy and fusion and 32 cases corpectomy and fusion. Preoperative CT images were analyzed for operation breakthrough and decompression range. During surgery, the ossified mass was excised or floated and the arachnoid reserved in order to reduce dural damage. Sutures coupled with gelatin sponge or muscle pedicle were applied to repair dural defects. After surgery, patients were confined to bed to allow for drainage or puncture. RESULTS:Fifteen cases of dural defects were recognized intraoperatively. Postoperatively, 5 patients developed CSFL. Partially cut dura with intact arachnoid occurred in one patient who developed a CSF pseudocyst. No cases required secondary operations or shunt placement and all exhibited good wound healing, with JOA scores increasing from 7.30 ± 1.08 to 13.70 ± 0.81 points and improvement rates of 65.98% ± 7.35%. CONCLUSION:During anterior surgical treatment for severe OPLL, CSFL can be prevented and treated through careful analysis of CT images, meticulous operative technique, careful handling of the ossified mass, and intra-operative repair of dural damage.
journal_name
Orthop Surgjournal_title
Orthopaedic surgeryauthors
Lei T,Shen Y,Wang LF,Cao JM,Ding WY,Ma QHdoi
10.1111/os.12007subject
Has Abstractpub_date
2012-11-01 00:00:00pages
247-52issue
4eissn
1757-7853issn
1757-7861journal_volume
4pub_type
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12321
更新日期：2017-08-01 00:00:00
abstract：:To observe the morphology character of the anterior epidural space at the L4-5 disc level and to provide an anatomical basis for safely and accurately performing a percutaneous endoscopic lumbar discectomy (PELD). Fifty-five cases with L5 S1 lumbar disc herniation were included in this study, and cases with L4-5 disea...
journal_title：Orthopaedic surgery
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doi：10.1111/os.12325
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pub_type： 杂志文章,随机对照试验
doi：10.1111/os.12511
更新日期：2019-08-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12297
更新日期：2016-11-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
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更新日期：2019-12-01 00:00:00
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pub_type： 杂志文章
doi：10.1111/os.12818
更新日期：2020-12-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12624
更新日期：2020-02-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章,评审
doi：10.1111/os.12149
更新日期：2015-02-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12506
更新日期：2019-08-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12534
更新日期：2019-10-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12568
更新日期：2020-04-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/j.1757-7861.2009.00020.x
更新日期：2009-05-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章,实务指引
doi：10.1111/os.12454
更新日期：2019-04-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12345
更新日期：2017-08-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
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更新日期：2013-11-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章,多中心研究
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更新日期：2019-08-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章,随机对照试验
doi：10.1111/os.12092
更新日期：2014-02-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12049
更新日期：2013-08-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12450
更新日期：2019-06-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章,随机对照试验
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/j.1757-7861.2011.00153.x
更新日期：2011-11-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章,评审
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更新日期：2020-08-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12634
更新日期：2020-06-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12042
更新日期：2013-05-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12544
更新日期：2019-12-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12775
更新日期：2020-12-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12593
更新日期：2020-02-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12231
更新日期：2016-05-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
doi：10.1111/os.12623
更新日期：2020-04-01 00:00:00
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journal_title：Orthopaedic surgery
pub_type： 杂志文章
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更新日期：2020-06-01 00:00:00
