Multi-level
cervical spondylosis and ossification of the posterior longitudinal ligament (OPLL) are well-documented causes of
myelopathy. The choice of
surgical procedures remain controversial. Between January 1983 and December 1987, we have performed anterior cervical vertebrectomy in 45 patients with cervical
myelopathy caused by multi-level
spondylosis and OPLL. They consisted of 19 patients with
cervical spondylosis, 12 with OPLL, and 14 with combined lesions of both
cervical spondylosis and OPLL. There were 32 men and 13 women. The mean age was 55 years, ranging from 35 to 70 years. In all of our 45 patients, anterior vertebrectomy,
discectomy, removal of posterior
osteophytes and OPLL, and interbody fusion were done for progressive
myelopathy refractory to
conservative treatment. In 2 of 45 patients, 5 vertebral bodies were resected; in 3 patients, 4 vertebral bodies were resected; in 12 patients, 3 vertebral bodies were resected, in 19 patients, 2 vertebral bodies were resected; and in 9 patients, 1 vertebral body was resected. Thirty-nine of 45 patients (87%) had good results. Neurological signs did not improve in 5 patients (11%). One patient died because of
agranulocytosis secondary to treatment with
antibiotics. In conclusion, cervical cord compression caused by lesions located principally in the anterior aspect of the spinal canal may be completely relieved via anterior vertebrectomy,
discectomy, removal of the calcified ligament, and fusion.