Surgical treatment of ossification of the posterior longitudinal ligament and its outcomes: Posterior surgery by laminoplasty

Study Design: Review article. Objective: To discuss the history, indication, surgical outcomes, prognostic factors, and complications of laminoplasty for ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Summary of Background Data: OPLL usually requires surgery, which often involves indirect decompression by the posterior approach. Of the posterior procedures for OPLL, laminoplasty is the favored treatment. Here, we review the previously published literature on laminoplasty for OPLL. Methods: PubMed and previously published English and Japanese book chapters were searched for posterior procedures for treating OPLL. Results: There is a large body of literature on OPLL and its treatment. Based on a review of the literature, the history, indication, surgical outcomes, prognostic factors, and complications of laminoplasty for OPLL were examined. The results showed that long-term outcomes of both the open-door and double-door types of laminoplasty are favorable, although late neurological deterioration occurs in some patients. Preoperative kyphosis of the cervical spine and severe (>60%) compromise of the spinal canal by OPLL appear to be the limiting factors for the indication of laminoplasty. Complications of laminoplasty include segmental motor palsy, lamina closure, and axial symptoms. Conclusion: Laminoplasty is a feasible surgical option for OPLL if candidate patients are appropriately selected.