Radiological influencing factors of the effectiveness of posterior cervical surgery for multilevel ossification of the posterior longitudinal ligament

Abstract Background In patients with multilevel cervical ossification of posterior longitudinal ligament (OPLL), whether radiological factors affect the efficacy of posterior cervical surgery and which posterior surgery is more suitable and better in patients with different imaging manifestations remain to be elucidated. Methods From January 2012 to January 2018, 141 patients with multi-segmental OPLL underwent posterior cervical surgery, including 73 cases of laminoplasty (LP group) and 68 cases of laminectomy with fusion (LF group). Clinical and radiological results were compared between the groups. Patients were followed up for at least 2 years. Results At the last follow-up, significant differences in neck disability index (NDI), cervical range of motion, and C2–C7 Cobb angle were found between the two groups (P < 0.05). In the cervical kyphosis, K-line-negative, and OPLL occupying ratio(OR) > 60% groups, the