Advances in surgical strategies for ossification of posterior longitudinal ligament involving the C2 segment

Chinese Journal of Reparative and Reconstructive Surgery, 2023 · DOI: 10.7507/1002-1892.202302039 · Published: June 1, 2023

Surgery Spinal Disorders

Simple Explanation

This paper reviews surgical options for cervical ossification of the posterior longitudinal ligament (OPLL) specifically affecting the C2 segment, a complex subtype of cervical OPLL. Different posterior surgical approaches like laminectomy, laminoplasty, and dome-like laminoplasty are discussed, highlighting their suitability for specific patient conditions based on factors like K-line and R-line. The review also mentions newer techniques like the anterior Shelter technique and double-dome laminoplasty, outlining their advantages and limitations in addressing C2 segment OPLL.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Laminectomy is suitable for multi-segment OPLL, often with screw fixation, providing sufficient decompression but sacrificing cervical mobility.
2
Canal-expansive laminoplasty is beneficial for K-line positive patients, preserving cervical mobility but with risks of postoperative ossification progression.
3
The anterior Shelter technique directly decompresses but demands high surgical skill and carries risks like dural tears and nerve damage.

Research Summary

The review focuses on surgical strategies for cervical OPLL involving the C2 segment, emphasizing the complexity of this specific subtype and the challenges in treatment. Posterior approaches remain the primary surgical option due to relative simplicity, but these techniques may not fully restore cervical curvature and can result in axial symptoms and C5 nerve root palsy. Future research should focus on the etiology of OPLL and the development of non-surgical treatments, as well as establishing a systematic treatment strategy for C2-involved cervical OPLL.

Practical Implications

Surgical Strategy Selection

Surgeons should carefully assess patients based on factors like K-line, R-line, and cervical alignment to determine the most appropriate surgical technique for C2-involved OPLL.

Technological Advancements

The review highlights the potential of innovative techniques like the Shelter technique and computer-assisted navigation, which could improve surgical outcomes for complex C2 OPLL cases.

Future Research Directions

Further research into the underlying causes of OPLL and non-surgical treatment options, such as exosomal miR-140-5p, may offer new avenues for managing and preventing OPLL progression.

Advances in surgical strategies for ossification of posterior longitudinal ligament involving the C2 segment

Simple Explanation

Key Findings

Research Summary

Practical Implications

Surgical Strategy Selection

Technological Advancements

Future Research Directions

Study Limitations

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Was this summary helpful?

Advances in surgical strategies for ossification of posterior longitudinal ligament involving the C2 segment

Simple Explanation

Key Findings

Research Summary

Practical Implications

Surgical Strategy Selection

Technological Advancements

Future Research Directions

Study Limitations

Your Feedback

Was this summary helpful?