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Comparison of clinical and radiological outcomes in cervical laminoplasty versus laminectomy with fusion in patients with ossification of the posterior longitudinal ligament.
Neurosurg Rev. 2020 Oct; 43(5):1409-1421.NR

Abstract

This study aimed to comparatively assess cervical sagittal alignment, progression of ossification of the posterior longitudinal ligament (OPLL), and health-related quality of life (HRQOL) outcomes between patients who underwent cervical laminoplasty (CL) and those who underwent cervical laminectomy with fusion (LF) for cervical OPLL at more than three levels. We retrospectively evaluated consecutive 91 patients with cervical OPLL undergoing CL (n = 49) or LF (n = 42) who were followed up for at least 24 months (mean 38.6 months). We analyzed radiological measurements (C2-7 sagittal vertical axis [C2-7 SVA], C0-2 angle, C2-7 lordotic angle, T1 slope, and range of motion [ROM]), OPLL thickness, and clinical outcomes (visual analog scale [VAS], neck disability index [NDI], Short Form-36, and Japanese Orthopaedic Association [JOA] scores). Compared with preoperative levels, postoperative C2-7 SVA increased significantly increased in the LF (15.05 mm) and CL (7.86 mm) groups (P = 0.0021). Loss of cervical lordosis and ROM was significantly larger in the cervical LF group (P = 0.0296, P = 0.0004). Improvements in HRQOL, JOA recovery ratio, and VAS were similar between both groups, while NDI improved more significantly in the CL group (P = 0.0425). The postoperative neck VAS correlated positively with the change (Δ) of C2-7 SVA (P = 0.0174) and negatively with the change (Δ) of C2-7 lordotic angle (P = 0.0354). Progression of OPLL thickness in the LF (0.31 ± 0.37 mm) was significantly smaller than in the CL group (1.09 ± 0.64 mm) (P < 0.0001). CL was superior to LF in preserving cervical ROM, preoperative cervical lordosis, and minimizing neck disability. The stabilization obtained by adding instrumented fusion could suppress the progression of OPLL thickness.

Authors+Show Affiliations

Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. zunzae@hanmail.net. Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Dongil-ro 1342, Nowon-gu, Seoul, 01757, South Korea. zunzae@hanmail.net.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

31512014

Citation

Ha, Yoon, and Jun Jae Shin. "Comparison of Clinical and Radiological Outcomes in Cervical Laminoplasty Versus Laminectomy With Fusion in Patients With Ossification of the Posterior Longitudinal Ligament." Neurosurgical Review, vol. 43, no. 5, 2020, pp. 1409-1421.
Ha Y, Shin JJ. Comparison of clinical and radiological outcomes in cervical laminoplasty versus laminectomy with fusion in patients with ossification of the posterior longitudinal ligament. Neurosurg Rev. 2020;43(5):1409-1421.
Ha, Y., & Shin, J. J. (2020). Comparison of clinical and radiological outcomes in cervical laminoplasty versus laminectomy with fusion in patients with ossification of the posterior longitudinal ligament. Neurosurgical Review, 43(5), 1409-1421. https://doi.org/10.1007/s10143-019-01174-5
Ha Y, Shin JJ. Comparison of Clinical and Radiological Outcomes in Cervical Laminoplasty Versus Laminectomy With Fusion in Patients With Ossification of the Posterior Longitudinal Ligament. Neurosurg Rev. 2020;43(5):1409-1421. PubMed PMID: 31512014.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of clinical and radiological outcomes in cervical laminoplasty versus laminectomy with fusion in patients with ossification of the posterior longitudinal ligament. AU - Ha,Yoon, AU - Shin,Jun Jae, Y1 - 2019/09/11/ PY - 2019/04/05/received PY - 2019/09/03/accepted PY - 2019/08/06/revised PY - 2019/9/13/pubmed PY - 2021/2/16/medline PY - 2019/9/13/entrez KW - Cervical myelopathy KW - Laminectomy with fusion KW - Laminoplasty KW - Ossification of posterior longitudinal ligament KW - Sagittal alignment SP - 1409 EP - 1421 JF - Neurosurgical review JO - Neurosurg Rev VL - 43 IS - 5 N2 - This study aimed to comparatively assess cervical sagittal alignment, progression of ossification of the posterior longitudinal ligament (OPLL), and health-related quality of life (HRQOL) outcomes between patients who underwent cervical laminoplasty (CL) and those who underwent cervical laminectomy with fusion (LF) for cervical OPLL at more than three levels. We retrospectively evaluated consecutive 91 patients with cervical OPLL undergoing CL (n = 49) or LF (n = 42) who were followed up for at least 24 months (mean 38.6 months). We analyzed radiological measurements (C2-7 sagittal vertical axis [C2-7 SVA], C0-2 angle, C2-7 lordotic angle, T1 slope, and range of motion [ROM]), OPLL thickness, and clinical outcomes (visual analog scale [VAS], neck disability index [NDI], Short Form-36, and Japanese Orthopaedic Association [JOA] scores). Compared with preoperative levels, postoperative C2-7 SVA increased significantly increased in the LF (15.05 mm) and CL (7.86 mm) groups (P = 0.0021). Loss of cervical lordosis and ROM was significantly larger in the cervical LF group (P = 0.0296, P = 0.0004). Improvements in HRQOL, JOA recovery ratio, and VAS were similar between both groups, while NDI improved more significantly in the CL group (P = 0.0425). The postoperative neck VAS correlated positively with the change (Δ) of C2-7 SVA (P = 0.0174) and negatively with the change (Δ) of C2-7 lordotic angle (P = 0.0354). Progression of OPLL thickness in the LF (0.31 ± 0.37 mm) was significantly smaller than in the CL group (1.09 ± 0.64 mm) (P < 0.0001). CL was superior to LF in preserving cervical ROM, preoperative cervical lordosis, and minimizing neck disability. The stabilization obtained by adding instrumented fusion could suppress the progression of OPLL thickness. SN - 1437-2320 UR - https://www.unboundmedicine.com/medline/citation/31512014/Comparison_of_clinical_and_radiological_outcomes_in_cervical_laminoplasty_versus_laminectomy_with_fusion_in_patients_with_ossification_of_the_posterior_longitudinal_ligament_ L2 - https://dx.doi.org/10.1007/s10143-019-01174-5 DB - PRIME DP - Unbound Medicine ER -