The effect of intraoperative curvature reconstruction on the efficacy of double-door laminoplasty for cervical ossification of posterior longitudinal ligament with K-line(+)in extension position
Objective:To investigate the clinical efficacy of double-door laminoplasty with intraoperative cervical curvature adjustment and parallel muscle reconstruction for the treatment of cervical ossification of posterior longitudinal ligament(OPLL)with K-line(+)in the extension position.Methods:A retrospective analysis was conducted on 50 OPLL patients with K-line(-)in the standard position and K-line(+)in the extension position who underwent cervical double-door laminoplasty from August 2020 to March 2022.The patients were divided into two groups based on whether the cervical curvature adjustments were performed intraoperatively:conventional reconstruction group(25 patients)and curvature reconstruction group(25 patients).Surgical duration,intraoperative blood loss,the preoperative and 3-month postoperative Japanese Orthopedic Association(JOA)score,the JOA improvement rate,and cervical physiological curvature(CLA),as well as the proportion of patients experiencing head lift weakness and axial symptoms at 3 months postoperatively were compared between the two groups.Results:There were no statistically significant differences in surgical duration and blood loss,between the two groups(P＞0.05).Three months after surgery,in the conventional reconstruction group,the JOA score improved from(10.9±0.7)to(14.4±0.7),with an improvement rate of(56.7±11.4)％;CLA increased from 10.3°±1.0° preoperatively to 11.2°±0.9°.The JOA score in the curvature reconstruction group improved from(10.8±0.7)preoperatively to(15.0±0.5),with an improvement rate of(68.3±7.1)％;CLA increased from 10.4°±0.8° preoperatively to 14.7°±1.2°.At 3 months postoperatively,there were statistically significant differences between the two groups in JOA score,JOA score improvement rate,CLA,and the proportion of patients experiencing axial symptoms(P＜0.05),while the proportion of patients experiencing head lift weakness showed no statistically significant difference(P＞0.05).Conclusions:Intraoperative adjustment of cervical curvature and muscle reconstruction in double-opening vertebroplasty effectively improves postoperative CLA and alleviates clinical symptoms in OPLL patients with K-lines(-)in the standard position and K-lines(+)in the extension position.
Cervical VertebraOssification of Posterior Longitudinal LigamentDouble-door LaminoplastyK-line
万方数据
维普
