Anatomical research on cervical posterior longitudinal ligament and clinical study on epidural cervical disc extrusion(ECDE)by excising cervical posterior longitudinal ligament through anterior approach

Objective To oberserve To investigate therapeutic effects of anterior discectomy and intervertebral bone graft fusion for epidural cervical disc extrusion(ECDE) by excising the cervical posterior longitudinal ligament(PLL) according to the result of anatomical research.Methods Whole cervical spinal columns from C2 through C7 were from 10 human adult cadavers of Chinese origin.The segmental widths of cervical PLL were measured under a surgical microscope,and the measuremental results were analysed by statistics softwares.The clinical data of 42 cases Between January 2004 and December 2010 of ECDE operated through anterior approach by excising cervical PLL were reviewed,And the clinical outcome was analysed on the JOA grade method(17 grades).Results The change of the widths of the cervical PLL accompanied with that of the cervical segments,but no differences were detected in PLL widths between the segmental ligments at the vertebral bodies and intervertebral discs on all levels.35 cases were sufficient follow-up in 42 cases.The mean time of follow-up was 19.2(range,3 to 56months).The clinical outcome was graded as execellent in 22 cases,good in 8 cases,effective in 4case,ineffective in 1 case.Totally,85.7 percent of those cases was fine and average improvement rate was 74 percent.Conclusion This investigation suggests that anatomic study provided data of cervical PLL which shoud be excised when curing ECDE by discectomy through anterior approach,which ensure a good outcomes.