Ossification of the posterior longitudinal ligament (OPLL) is a common cause of cervical myelopathy. Laminoplasty is a surgical method widely applied for multi-level cervical OPLL. However, laminoplasty achieves spinal cord decompression through a posterior shift of the cord, which makes it a poor option for patients with cervical kyphosis and significant compression.

For multi-level OPLL patients with kyphotic alignment, anterior cervical corpectomy and fusion (ACCF) is superior to laminoplasty. ACCF directly decompresses the spinal cord by removing the OPLL mass, and its success is independent of cervical alignment. However, ACCF for OPLL is demanding and requires perioperative management of troublesome complications, including cerebrospinal leaks and graft-related complications.

In the vertebral body sliding osteotomy (VBSO), as a replacement for ACCF, the vertebral body is translated anteriorly to widen the spinal canal, minimizing the need for direct removal of the ossified mass. It has fewer complications as it minimizes direct separation of OPLL from the dura and has better ability to restore cervical lordosis than ACCF.

Professor Dong-Ho Lee is talking on "Vertebral Body Sliding Osteotomy", do not miss it!

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