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Expansive open-door laminoplasty versus laminectomy and instrumented fusion for cases with cervical ossification of the posterior longitudinal ligament and straight lordosis.
Eur Spine J. 2017 04; 26(4):1173-1180.ES

Abstract

PURPOSE

To identify whether expansive open-door laminoplasty (Lam) is more appropriate than laminectomy and instrumented fusion (LIF) for cases with ossification of the posterior longitudinal ligament (OPLL) and straight cervical lordosis.

METHODS

A total of 67 cases were included and divided into Group Lam (n = 32) and Group LIF (n = 35), and the mean follow-up periods were 38 and 42 months, respectively. The cervical lordosis was elevated by C2-7 Cobb angle and cervical sagittal balance by C2-C7 sagittal vertical axis (SVA). Japanese Orthopedic Association (JOA), neurological recovery rate (RR) being calculated by the JOA, visual analog scale (VAS) and neck disability index (NDI) were used to assess clinical outcomes.

RESULTS

Differences in general data between two groups were not significant. Total blood loss and operation duration in Group Lam were both significantly less than that in the Group LIF. By the final follow-up, the cervical lordosis significantly decreased in Group Lam and increased in Group LIF, the SVA significantly increased in Group Lam and kept unchanged in Group LIF, and the JOA, VAS, NDI significantly improved in both groups. Although there was no significant difference in RR between the two groups, cases in Group Lam had significantly larger incidence of postoperative kyphosis and kyphotic change rate, and less VAS, NDI and incidence of axial pain than cases in Group LIF.

CONCLUSIONS

When compared with the LIF, the Lam is recommended for cases with OPLL and straight cervical lordosis when taking comparable neurological recovery, less axial pain and better neck function improvement into consideration.

Authors+Show Affiliations

Department of Orthopedics, Jinling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China.Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China.Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China.Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China.Department of Orthopedics, Jinling Hospital, Medicine College, Nanjing University, Nanjing, 210002, Jiangsu, China.Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China. chenspinecz@hotmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28028648

Citation

Liu, Xiaowei, et al. "Expansive Open-door Laminoplasty Versus Laminectomy and Instrumented Fusion for Cases With Cervical Ossification of the Posterior Longitudinal Ligament and Straight Lordosis." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 26, no. 4, 2017, pp. 1173-1180.
Liu X, Chen Y, Yang H, et al. Expansive open-door laminoplasty versus laminectomy and instrumented fusion for cases with cervical ossification of the posterior longitudinal ligament and straight lordosis. Eur Spine J. 2017;26(4):1173-1180.
Liu, X., Chen, Y., Yang, H., Li, T., Xu, B., & Chen, D. (2017). Expansive open-door laminoplasty versus laminectomy and instrumented fusion for cases with cervical ossification of the posterior longitudinal ligament and straight lordosis. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 26(4), 1173-1180. https://doi.org/10.1007/s00586-016-4912-7
Liu X, et al. Expansive Open-door Laminoplasty Versus Laminectomy and Instrumented Fusion for Cases With Cervical Ossification of the Posterior Longitudinal Ligament and Straight Lordosis. Eur Spine J. 2017;26(4):1173-1180. PubMed PMID: 28028648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Expansive open-door laminoplasty versus laminectomy and instrumented fusion for cases with cervical ossification of the posterior longitudinal ligament and straight lordosis. AU - Liu,Xiaowei, AU - Chen,Yu, AU - Yang,Haisong, AU - Li,Tiefeng, AU - Xu,Bin, AU - Chen,Deyu, Y1 - 2016/12/27/ PY - 2016/04/25/received PY - 2016/12/04/accepted PY - 2016/11/06/revised PY - 2016/12/29/pubmed PY - 2018/1/24/medline PY - 2016/12/29/entrez KW - Expansive open-door laminoplasty KW - Laminectomy and instrumented fusion KW - Ossification of the posterior longitudinal ligament KW - Straight lordosis SP - 1173 EP - 1180 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 26 IS - 4 N2 - PURPOSE: To identify whether expansive open-door laminoplasty (Lam) is more appropriate than laminectomy and instrumented fusion (LIF) for cases with ossification of the posterior longitudinal ligament (OPLL) and straight cervical lordosis. METHODS: A total of 67 cases were included and divided into Group Lam (n = 32) and Group LIF (n = 35), and the mean follow-up periods were 38 and 42 months, respectively. The cervical lordosis was elevated by C2-7 Cobb angle and cervical sagittal balance by C2-C7 sagittal vertical axis (SVA). Japanese Orthopedic Association (JOA), neurological recovery rate (RR) being calculated by the JOA, visual analog scale (VAS) and neck disability index (NDI) were used to assess clinical outcomes. RESULTS: Differences in general data between two groups were not significant. Total blood loss and operation duration in Group Lam were both significantly less than that in the Group LIF. By the final follow-up, the cervical lordosis significantly decreased in Group Lam and increased in Group LIF, the SVA significantly increased in Group Lam and kept unchanged in Group LIF, and the JOA, VAS, NDI significantly improved in both groups. Although there was no significant difference in RR between the two groups, cases in Group Lam had significantly larger incidence of postoperative kyphosis and kyphotic change rate, and less VAS, NDI and incidence of axial pain than cases in Group LIF. CONCLUSIONS: When compared with the LIF, the Lam is recommended for cases with OPLL and straight cervical lordosis when taking comparable neurological recovery, less axial pain and better neck function improvement into consideration. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/28028648/Expansive_open_door_laminoplasty_versus_laminectomy_and_instrumented_fusion_for_cases_with_cervical_ossification_of_the_posterior_longitudinal_ligament_and_straight_lordosis_ L2 - https://doi.org/10.1007/s00586-016-4912-7 DB - PRIME DP - Unbound Medicine ER -