Cervical ossification of posterior longitudinal ligament treated with modified laminoplasty:10-year follow-up
Objective:To observe the 10-year follow-up results of modified laminoplasty(mLP),namely the unilateral open-door laminoplasty with posterior muscle-ligament complex preservation,for cervical ossification of posterior longitudinal ligament(OPLL).Methods:A retrospective analysis was conducted on 33 cervical OPLL patients who underwent mLP from January 2006 to December 2012 and completed follow-ups of over 10 years with complete clinical and imaging data.Among them,17 patients underwent mLP alone,13 patients underwent mLP combined with anterior cervical fusion(11 patients with anterior cervical discectomy and fusion,and 2 patients with anterior cervical corpectomy and fusion),and 3 patients underwent mLP combined with posterior lateral mass screw fixation and fusion.The modified Japanese Orthopedic Association(mJOA)score,visual analog scale(VAS)and neck disability index(NDI)were used to evaluate the neurological function,neck pain severity and the impact of neck pain on cervical function and quality of life before surgery and at the final follow-up.Additionally,cervical curvature,range of motion(ROM)and C2-C7 sagittal vertical axis(SVA)were measured using cervical X-ray in neutral,lateral,and flexion-extension positions.Results:The patients were followed up for 120-167 months,with an average follow-up time of(134.6±11.4)months.At the final follow-up,there was a significant improvement in mJOA score compared to the preoperative score(P＜0.001).However,there was no statistically significant difference in NDI score and neck pain VAS score compared to preoperative values(both P＞0.05).At the final follow-up,14 patients(42.4％)still had axil syndromes,however,the severity was mild and no medication was required.No patients experienced C5 nerve root palsy and reoperation.Patients treated with mLP,whether combined with fusion or not,showed a decrease in cervical ROM and curvature in hyperextension and hyperflexion positions at the final follow-up compared to preoperative values(all P＜0.05),while SVA showed no statistically significant difference compared to preoperative values(P＞0.05).Conclusions:After 10-year follow-up,mLP for OPLL results in favorable outcomes in terms of clinical improvement and the preservation of cervical sagittal balance.However,the incidence of axial symptoms remains relatively high.
Cervical VertebraOssification of Posterior Longitudinal LigamentLaminoplastyLong-term Follow-up
万方数据
维普
