Surgical intervention of dysphagia caused by Ossification of the Anterior Longitudinal Ligament
Background: Ossification of the anterior longitudinal ligament (OALL) of the cervical spine is a common condition but rarely results in dysphagia. Here, we present a case of dysphagia caused by OALL, successfully managed with surgical intervention. Case: A 79-year-old female patient presented with dysphagia, having been unable to ingest any medication for one year. She had a medical history of diabetes mellitus. The patient was 153 cm tall, weighed 84 kg, and was severely obese, with a BMI of 35.9. Cervical radiography and simple CT revealed OALL at C4-7. Preoperative Videofluoroscopy(VF) demonstrated obstruction of oral medication passage due to OALL. Given the patient’s difficulty in taking hypoglycemic medications and poor glycemic control, surgical intervention was pursued. The patient underwent anterior osteotomy via the anterior cervical approach, resulting in significant postoperative alleviation of dysphagia. Subsequent radiography and CT confirmed the removal of ossification, with VF indicating improvement in dysphagia. No recurrence of OALL was observed one-year post-surgery. Conclusions: We encountered a case of ossification of the anterior longitudinal ligament leading to dysphagia. While there is no clear-cut indication for surgery, we advocate surgical intervention in cases where activities of daily living are compromised due to dysphagia.
