PMC8026211_01
(A), (B) Sagittal computed tomography (CT) scan of the neck shows an ankylosed cervical spine secondary to ossification of the anterior and posterior longitudinal ligaments. Laminectomy at the C2, C5, and C6 levels and laminoplasty at the C3 and C4 levels had been performed in the past. (C) Axial CT scan of the neck at the C4/5 level shows airway obstruction due to extensive anterior hyperostosis and thickening of the surrounding soft tissues (white arrow).
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Significant anterior protrusion of the ossified anterior longitudinal ligament at the C4-5 level was also observed (Fig. 1A). The surrounding soft tissues at the level of the hyoid bone were markedly swollen, and the airway was obstructed (Fig. 1B, C).
Intraoperative photograph.. An extensive osteophytic mass involving the anterior longitudinal ligament has been easily exposed, with no peripheral adhesions.
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The next day, the patient underwent anterior drilling of the extensive osteophytes on the anterior longitudinal ligament (Fig. 2).
Lateral radiographs of the cervical spine. (A) Five days after surgery, the soft-tissue swelling has reduced and no airway narrowing can be recognized. (B) Six months after surgery. (C) 3 years after surgery, the osteophytes have slightly enlarged.
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In fact, lateral radiography of the cervical spine demonstrated slight enlargement of the osteophytes 3 years later (Fig. 3), and we continued to monitor the patient carefully.