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Of 14 patients who were wheelchair bound before surgery, 12 walked independently on follow-up assessment of 6 months. All patients had successful arthrodesis in the surgically treated segments. There were no infective- or implant-related complications. Decision making in the surgical management of cervical OPLL is still controversial. The concept of spinal instability has been shown to be a nodal point in the pathogenesis of OPLL, and "only-spinal fixation" can be considered a rationale for an appropriate surgical treatment. Decision mak