Postoperative magnetic resonance imaging assessment for potential compressive effects of retained posterior longitudinal ligament after anterior cervical fusions

A cross-sectional study

Kingsley R. Chin, Gary Ghiselli, Vanessa Cumming, Christopher G. Furey, Jung Yoo, Sanford E. Emery

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

STUDY DESIGN.: A cross-sectional study. OBJECTIVE.: To assess using postoperative magnetic resonance imaging whether the posterior longitudinal ligament (PLL) caused residual cord compression after anterior cervical decompression and fusion (ACDF) in a series of patients in whom the PLL was retained. SUMMARY OF BACKGROUND DATA.: There is a lack of data evaluating the postoperative compressive effects of the PLL in patients undergoing ACDF providing guidance as to whether to remove or retain the PLL during discectomy to facilitate adequate decompression. METHODS.: Postoperative gadolinium enhanced magnetic resonance images were reviewed in a series of 33 patients who underwent ACDF for cervical radiculomyelopathy and who had persistent or recurrent postoperative symptoms. Patients with ossification of the posterior longitudinal ligament or with a herniated disc behind the PLL were excluded from this study. RESULTS.: There were no cases of discernible compression by the retained PLL identified on the magnetic resonance image (P <0.001) as assessed by 2 independent reviewers. Four patients underwent subsequent revision surgery unrelated to the PLL. CONCLUSION.: We were unable to demonstrate magnetic resonance imaging evidence to suggest that the retained PLL caused compression after ACDF in this patient cohort. Therefore we suggest that removing the PLL should be considered for reasons other than concern about residual compression.

Original languageEnglish (US)
Pages (from-to)253-256
Number of pages4
JournalSpine
Volume38
Issue number3
DOIs
StatePublished - Feb 1 2013

Fingerprint

Longitudinal Ligaments
Cross-Sectional Studies
Magnetic Resonance Imaging
Decompression
Magnetic Resonance Spectroscopy
Ossification of Posterior Longitudinal Ligament
Diskectomy
Intervertebral Disc Displacement
Gadolinium
Reoperation

Keywords

  • anterior cervical decompression and fusion
  • compressive effects of posterior longitudinal ligament
  • postoperative magnetic resonance imaging

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Postoperative magnetic resonance imaging assessment for potential compressive effects of retained posterior longitudinal ligament after anterior cervical fusions : A cross-sectional study. / Chin, Kingsley R.; Ghiselli, Gary; Cumming, Vanessa; Furey, Christopher G.; Yoo, Jung; Emery, Sanford E.

In: Spine, Vol. 38, No. 3, 01.02.2013, p. 253-256.

Research output: Contribution to journalArticle

Chin, Kingsley R. ; Ghiselli, Gary ; Cumming, Vanessa ; Furey, Christopher G. ; Yoo, Jung ; Emery, Sanford E. / Postoperative magnetic resonance imaging assessment for potential compressive effects of retained posterior longitudinal ligament after anterior cervical fusions : A cross-sectional study. In: Spine. 2013 ; Vol. 38, No. 3. pp. 253-256.
@article{4ce3589689294214b6dd0c93e45722f9,
title = "Postoperative magnetic resonance imaging assessment for potential compressive effects of retained posterior longitudinal ligament after anterior cervical fusions: A cross-sectional study",
abstract = "STUDY DESIGN.: A cross-sectional study. OBJECTIVE.: To assess using postoperative magnetic resonance imaging whether the posterior longitudinal ligament (PLL) caused residual cord compression after anterior cervical decompression and fusion (ACDF) in a series of patients in whom the PLL was retained. SUMMARY OF BACKGROUND DATA.: There is a lack of data evaluating the postoperative compressive effects of the PLL in patients undergoing ACDF providing guidance as to whether to remove or retain the PLL during discectomy to facilitate adequate decompression. METHODS.: Postoperative gadolinium enhanced magnetic resonance images were reviewed in a series of 33 patients who underwent ACDF for cervical radiculomyelopathy and who had persistent or recurrent postoperative symptoms. Patients with ossification of the posterior longitudinal ligament or with a herniated disc behind the PLL were excluded from this study. RESULTS.: There were no cases of discernible compression by the retained PLL identified on the magnetic resonance image (P <0.001) as assessed by 2 independent reviewers. Four patients underwent subsequent revision surgery unrelated to the PLL. CONCLUSION.: We were unable to demonstrate magnetic resonance imaging evidence to suggest that the retained PLL caused compression after ACDF in this patient cohort. Therefore we suggest that removing the PLL should be considered for reasons other than concern about residual compression.",
keywords = "anterior cervical decompression and fusion, compressive effects of posterior longitudinal ligament, postoperative magnetic resonance imaging",
author = "Chin, {Kingsley R.} and Gary Ghiselli and Vanessa Cumming and Furey, {Christopher G.} and Jung Yoo and Emery, {Sanford E.}",
year = "2013",
month = "2",
day = "1",
doi = "10.1097/BRS.0b013e3182796e9c",
language = "English (US)",
volume = "38",
pages = "253--256",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Postoperative magnetic resonance imaging assessment for potential compressive effects of retained posterior longitudinal ligament after anterior cervical fusions

T2 - A cross-sectional study

AU - Chin, Kingsley R.

AU - Ghiselli, Gary

AU - Cumming, Vanessa

AU - Furey, Christopher G.

AU - Yoo, Jung

AU - Emery, Sanford E.

PY - 2013/2/1

Y1 - 2013/2/1

N2 - STUDY DESIGN.: A cross-sectional study. OBJECTIVE.: To assess using postoperative magnetic resonance imaging whether the posterior longitudinal ligament (PLL) caused residual cord compression after anterior cervical decompression and fusion (ACDF) in a series of patients in whom the PLL was retained. SUMMARY OF BACKGROUND DATA.: There is a lack of data evaluating the postoperative compressive effects of the PLL in patients undergoing ACDF providing guidance as to whether to remove or retain the PLL during discectomy to facilitate adequate decompression. METHODS.: Postoperative gadolinium enhanced magnetic resonance images were reviewed in a series of 33 patients who underwent ACDF for cervical radiculomyelopathy and who had persistent or recurrent postoperative symptoms. Patients with ossification of the posterior longitudinal ligament or with a herniated disc behind the PLL were excluded from this study. RESULTS.: There were no cases of discernible compression by the retained PLL identified on the magnetic resonance image (P <0.001) as assessed by 2 independent reviewers. Four patients underwent subsequent revision surgery unrelated to the PLL. CONCLUSION.: We were unable to demonstrate magnetic resonance imaging evidence to suggest that the retained PLL caused compression after ACDF in this patient cohort. Therefore we suggest that removing the PLL should be considered for reasons other than concern about residual compression.

AB - STUDY DESIGN.: A cross-sectional study. OBJECTIVE.: To assess using postoperative magnetic resonance imaging whether the posterior longitudinal ligament (PLL) caused residual cord compression after anterior cervical decompression and fusion (ACDF) in a series of patients in whom the PLL was retained. SUMMARY OF BACKGROUND DATA.: There is a lack of data evaluating the postoperative compressive effects of the PLL in patients undergoing ACDF providing guidance as to whether to remove or retain the PLL during discectomy to facilitate adequate decompression. METHODS.: Postoperative gadolinium enhanced magnetic resonance images were reviewed in a series of 33 patients who underwent ACDF for cervical radiculomyelopathy and who had persistent or recurrent postoperative symptoms. Patients with ossification of the posterior longitudinal ligament or with a herniated disc behind the PLL were excluded from this study. RESULTS.: There were no cases of discernible compression by the retained PLL identified on the magnetic resonance image (P <0.001) as assessed by 2 independent reviewers. Four patients underwent subsequent revision surgery unrelated to the PLL. CONCLUSION.: We were unable to demonstrate magnetic resonance imaging evidence to suggest that the retained PLL caused compression after ACDF in this patient cohort. Therefore we suggest that removing the PLL should be considered for reasons other than concern about residual compression.

KW - anterior cervical decompression and fusion

KW - compressive effects of posterior longitudinal ligament

KW - postoperative magnetic resonance imaging

UR - http://www.scopus.com/inward/record.url?scp=84873405420&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873405420&partnerID=8YFLogxK

U2 - 10.1097/BRS.0b013e3182796e9c

DO - 10.1097/BRS.0b013e3182796e9c

M3 - Article

VL - 38

SP - 253

EP - 256

JO - Spine

JF - Spine

SN - 0362-2436

IS - 3

ER -