Clinical and Radiological Outcomes of Anterior Approach Microscopic Surgery for the Pincer Mechanism in Cervical Spondylotic Myelopathy

Figure 2

Female, 70-year-old, weakness of limbs for 1 year. Preoperation JOA score was 10. Preoperation Cobb’s angle was 10.57° in lateral cervical X-ray. The MR scanning showed C3/4, C4/5, 5/6-disc herniation with posterior wrinkled and incrassated ligament Flava, leading to pincer spinal stenosis. The anterior and posterior occupying rate were 45.4% and 33.3% (a). The sagittal CT imaging showed ossification of the posterior longitudinal ligament (OPLL) in C4/5. (b). The spinal cord was decompressed sufficiently by ACDF of C3/4, C4/5, 5/6 (c). The OPLL was excised by ACDF without corpectomy, while the cage of C4/5 was implanted closer to the anterior vertebral body, leading to intervertebral plate height of C4/5 loss. The wrinkled and incrassated ligament Flava of C4/5 still existed (c&d). Cobb’s angle was 28.78°. Postoperation JOA score was 16 at 6th-month follow-up.

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(b)

(c)

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