Study Design: Systematic review and meta-analysis.

Objective: To compare the effectiveness and safety between anterior and posterior approach, and determine the best surgical methods for the treatment of ossification of the posterior longitudinal ligament (OPLL) in the cervical spine.

Methods: We searched the Cochrane Library, PubMed, CNKI and Wanfang Med Data databases from January 2007 to March 2018. Japanese Orthopaedic Association (JOA) scores, cervical lordosis, functional recovery rates, excellent and good outcomes of the surgical approaches, and complication and reoperation rates were analyzed. RevMan 5.3 was utilized for data analysis.

Results: Eleven studies were included in the meta-analysis. By comparing the anterior and posterior approaches for the treatment of OPLL in the cervical spine, statistically significant differences were found in the preoperative initial JOA, the postoperative final JOA scores, functional recovery rates, complication rates, excellent and good outcomes of the surgical approaches and reoperation rates. However, no statistically significant difference in the occurrence of the preoperative and postoperative cervical lordosis was noted.

Conclusion: The anterior approach is superior to the posterior approach in terms of the postoperative final JOA score, functional recovery rate, and clinical outcomes. Although the complication and reoperation rates of the anterior approach are higher than those of the posterior approach. We recommend the anterior approach for the treatment of OPLL when patients with occupying ratio ≥ 60%. In addition, high-quality studies with long-term follow-up and large sample size are also needed.

研究设计：系统评价和荟萃分析。

目的：比较前路和后路的有效性和安全性，确定治疗颈椎后纵韧带（OPLL）骨化的最佳手术方法。

方法：我们检索了 2007 年 1 月至 2018 年 3 月的 Cochrane Library、PubMed、CNKI 和 Wanfang Med Data 数据库。分析了再手术率。RevMan 5.3 用于数据分析。

结果： 11 项研究被纳入荟萃分析。通过比较前后入路治疗颈椎OPLL，术前初始JOA、术后最终JOA评分、功能恢复率、并发症发生率、手术入路优、良效果等差异有统计学意义。再手术率。然而，术前和术后颈椎前凸的发生率没有统计学上的显着差异。

结论：前路入路在术后最终JOA评分、功能恢复率和临床疗效方面优于后路入路。虽然前路的并发症和再次手术率高于后路。占位率≥60%的患者推荐前路治疗OPLL。此外，还需要具有长期随访和大样本量的高质量研究。