Corpectomy: Floating method for OPLL

Abstract

Anterior cervical corpectomy and fusion is an effective procedure for the treatment of ossification of the posterior longitudinal ligament (OPLL) because it provides direct decompression to the spinal cord and stabilizes the involved segments. The anterior floating method thins the ossification and disconnects it from the surrounding bony tissues, instead of resecting the OPLL. When freeing the ossification from the surrounding bone tissues, the top and bottom ends of the ossification are first released transversely and then disconnected from the pedicle that is situated laterally. When the thinned OPLL appears to be like a board floating on water, decompression of the spinal cord is complete. If the surrounding soft tissue is still hard, the margin of the ossification should be removed to obtain a sufficient decompression. For reconstruction, we normally use a fibular bone graft reinforced by an anterior plate. Alternative graft materials, such as allograft, prefabricated hydroxyapatite graft, titanium cage, etc., have been available, which decrease donor-site morbidity.