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Reoperation for Late Neurological Deterioration After Laminoplasty in Individuals With Degenerative Cervical Myelopathy: Comparison of Cases of Cervical Spondylosis and Ossification of the Posterior Longitudinal Ligament.
Spine (Phila Pa 1976). 2020 Aug 01; 45(15):E909-E916.S

Abstract

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

The objective of this study was to elucidate the rate and causes of reoperation for late neurological deterioration after cervical laminoplasty by comparing cases of cervical spondylotic myelopathy (CSM) with those of ossification of the posterior longitudinal ligament (OPLL).

SUMMARY OF BACKGROUND DATA

Although the long-term surgical outcomes of cervical laminoplasty in patients with CSM or OPLL are satisfactory, reoperation is sometimes required for late neurological deterioration after laminoplasty. However, limited information is available about long-term follow-up in such cases.

METHODS

This retrospective cohort study included 623 patients who underwent cervical laminoplasty for cervical myelopathy (average follow-up duration, 6.1 [range, 2-15] years). The rate of reoperations for late neurological deterioration (>6 mo after the initial surgery) was investigated.

RESULTS

Primary diagnoses were CSM and OPLL in 522 (83.8%) and 101 (16.2%) patients, respectively. During the follow-up period, 10 (1.6%) patients required reoperation: 7 (1.3%) in the CSM group and 3 (3.0%) in the OPLL group. No significant difference was found between the CSM and OPLL groups regarding patients requiring reoperation (P = 0.26). The mean elapsed time between primary surgery and reoperation was 4.7 ± 3.2 and 10.0 ± 5.7 years in the CSM and OPLL groups, respectively. The predicted risk percentages of reoperation at 10 years after primary surgery were 2.9% and 1.0% in the CSM and OPLL group, respectively. The causes of reoperation for CSM were C5 palsy in five, severe radiculopathy in one, and restenosis due to instability after laminoplasty in one case; the cause of reoperation for OPLL was enlargement of ossification in all three cases.

CONCLUSION

Although the clinical outcomes of laminoplasty were favorable in most patients, reoperation for late neurological deterioration was required in approximately 1.0% to 3.0% of CSM and OPLL cases within 10 years after laminoplasty.

LEVEL OF EVIDENCE

4.

Authors+Show Affiliations

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. Department of Orthopedic Surgery, Konankosei Hospital, Konan, Aichi, Japan.Department of Orthopedic Surgery, Konankosei Hospital, Konan, Aichi, Japan.Department of Orthopedic Surgery, Konankosei Hospital, Konan, Aichi, Japan.Department of Orthopedic Surgery, Konankosei Hospital, Konan, Aichi, Japan.Department of Orthopedic Surgery, Konankosei Hospital, Konan, Aichi, Japan.Department of Orthopedic Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan.Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

Pub Type(s)

Case Reports
Comparative Study
Journal Article

Language

eng

PubMed ID

32675602

Citation

Nakashima, Hiroaki, et al. "Reoperation for Late Neurological Deterioration After Laminoplasty in Individuals With Degenerative Cervical Myelopathy: Comparison of Cases of Cervical Spondylosis and Ossification of the Posterior Longitudinal Ligament." Spine, vol. 45, no. 15, 2020, pp. E909-E916.
Nakashima H, Kanemura T, Satake K, et al. Reoperation for Late Neurological Deterioration After Laminoplasty in Individuals With Degenerative Cervical Myelopathy: Comparison of Cases of Cervical Spondylosis and Ossification of the Posterior Longitudinal Ligament. Spine (Phila Pa 1976). 2020;45(15):E909-E916.
Nakashima, H., Kanemura, T., Satake, K., Ito, K., Ouchida, J., Morita, D., Ando, K., Kobayashi, K., Ishiguro, N., & Imagama, S. (2020). Reoperation for Late Neurological Deterioration After Laminoplasty in Individuals With Degenerative Cervical Myelopathy: Comparison of Cases of Cervical Spondylosis and Ossification of the Posterior Longitudinal Ligament. Spine, 45(15), E909-E916. https://doi.org/10.1097/BRS.0000000000003408
Nakashima H, et al. Reoperation for Late Neurological Deterioration After Laminoplasty in Individuals With Degenerative Cervical Myelopathy: Comparison of Cases of Cervical Spondylosis and Ossification of the Posterior Longitudinal Ligament. Spine (Phila Pa 1976). 2020 Aug 1;45(15):E909-E916. PubMed PMID: 32675602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reoperation for Late Neurological Deterioration After Laminoplasty in Individuals With Degenerative Cervical Myelopathy: Comparison of Cases of Cervical Spondylosis and Ossification of the Posterior Longitudinal Ligament. AU - Nakashima,Hiroaki, AU - Kanemura,Tokumi, AU - Satake,Kotaro, AU - Ito,Kenyu, AU - Ouchida,Jun, AU - Morita,Daigo, AU - Ando,Kei, AU - Kobayashi,Kazuyoshi, AU - Ishiguro,Naoki, AU - Imagama,Shiro, PY - 2020/7/18/entrez PY - 2020/7/18/pubmed PY - 2020/11/4/medline SP - E909 EP - E916 JF - Spine JO - Spine (Phila Pa 1976) VL - 45 IS - 15 N2 - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study was to elucidate the rate and causes of reoperation for late neurological deterioration after cervical laminoplasty by comparing cases of cervical spondylotic myelopathy (CSM) with those of ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: Although the long-term surgical outcomes of cervical laminoplasty in patients with CSM or OPLL are satisfactory, reoperation is sometimes required for late neurological deterioration after laminoplasty. However, limited information is available about long-term follow-up in such cases. METHODS: This retrospective cohort study included 623 patients who underwent cervical laminoplasty for cervical myelopathy (average follow-up duration, 6.1 [range, 2-15] years). The rate of reoperations for late neurological deterioration (>6 mo after the initial surgery) was investigated. RESULTS: Primary diagnoses were CSM and OPLL in 522 (83.8%) and 101 (16.2%) patients, respectively. During the follow-up period, 10 (1.6%) patients required reoperation: 7 (1.3%) in the CSM group and 3 (3.0%) in the OPLL group. No significant difference was found between the CSM and OPLL groups regarding patients requiring reoperation (P = 0.26). The mean elapsed time between primary surgery and reoperation was 4.7 ± 3.2 and 10.0 ± 5.7 years in the CSM and OPLL groups, respectively. The predicted risk percentages of reoperation at 10 years after primary surgery were 2.9% and 1.0% in the CSM and OPLL group, respectively. The causes of reoperation for CSM were C5 palsy in five, severe radiculopathy in one, and restenosis due to instability after laminoplasty in one case; the cause of reoperation for OPLL was enlargement of ossification in all three cases. CONCLUSION: Although the clinical outcomes of laminoplasty were favorable in most patients, reoperation for late neurological deterioration was required in approximately 1.0% to 3.0% of CSM and OPLL cases within 10 years after laminoplasty. LEVEL OF EVIDENCE: 4. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/32675602/Reoperation_for_Late_Neurological_Deterioration_After_Laminoplasty_in_Individuals_With_Degenerative_Cervical_Myelopathy:_Comparison_of_Cases_of_Cervical_Spondylosis_and_Ossification_of_the_Posterior_Longitudinal_Ligament_ L2 - https://doi.org/10.1097/BRS.0000000000003408 DB - PRIME DP - Unbound Medicine ER -