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Hiroshi Abe, Mitsuo Tsuru, Terufumi Ito, Yoshinobu Iwasaki and Mitsuyuki Koiwa

✓ Anterior decompression and fusion for treating ossification of the posterior longitudinal ligament of the cervical spine was performed in 12 patients. The central part of the vertebral body and the ossified area of the posterior longitudinal ligament were removed by means of a microrongeur and an air drill. The defect was filled with a long bone graft taken from the ilium. The operative results were excellent. Marked improvement of radicular and spinal cord signs was seen in all 12 cases. Three vertebral bodies were fused in one case, four in nine cases, and five in two cases. The highest level of fusion was C-2 and the lowest was T-1. It is considered that any ossification of the ligament below the C-2 level can be removed via an anterior approach as long as no more than five vertebral bodies are involved. Spinal computerized tomography was valuable in providing more detailed information about the stenotic spinal canal and the shape of the ossified ligament.

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Toyohiko Isu, Kazuo Miyasaka, Hiroshi Abe, Terufumi Ito, Yoshinobu Iwasaki, Mitsuo Tsuru, Kenichi Kitaoka and Minoru Tsunoda

✓ Atlantoaxial dislocation was found in three patients with neurofibromatosis. Roentgenographic findings included marked reduction of sagittal diameter at the C-1 vertebral level, and cervical spine abnormalities associated with mesodermal dysplasia, such as posterior scalloping of the cervical spinal bodies with dural ectasia and vertebral body deformity (vertebral body dysplasia). Although the relationship of the atlas and axis did not change with neck position, all three patients had progressive neurological deficits and were treated by decompressive surgery combined with fusion. The pathogenesis of atlantoaxial dislocation associated with neurofibromatosis is discussed.

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Yoshinobu Iwasaki, Minoru Akino, Hiroshi Abe, Mitsuo Tsuru, Kunio Tashiro, Kazuo Miyasaka, Kiyoshi Kaneda, Toyohiko Isu and Terufumi Ito

✓ Four cases of calcification of the cervical ligamentum flavum are reported, all in women over 60 years of age. Neurological findings were not significantly different from those of other cervical compressive diseases. Among radiological examinations, computerized tomography was the most valuable diagnostic tool. Calcification might have been induced by the degeneration or abnormal nutritional state of the ligamentum flavum. Endocrine abnormalities and inflammatory processes might also have been contributory factors.