Long-term efficacy of spinous process splitting laminoplasty using coralline hydroxyapatite for severe multisegmental cervical ossification of the posterior longitudinal ligament
Objective:To investigate the long-term clinical efficacy of spinous process splitting laminoplasty using coralline hydroxyapatite(SLAC)in the treatment of multisegmental severe cervical ossification of the posterior longitudinal ligament(OPLL).Methods:Clinical data of 47 patients with severe multisegmental cervical OPLL who underwent SLAC between May 2005 and July 2011 were retrospectively analyzed.There were 25 males and 22 females,aged 37 to 72 years,with an average age of(51.1±14.5)years.Twenty patients with a spinal canal occupying ratio＜60％were included into the compression group,and 27 patients with an occupying ratio ≥60％were included in the severe compression group.Neurological function was evaluated using the modified Japanese Orthopedic Association(mJOA)score and the neck disability index(NDI)both preoperatively and postoperatively,and imaging examinations were performed to observe the complications.Results:Forty-seven patients were followed up for 108-182 months,with an average of(131.5±24.1)months.Compared to the preoperative scores,the mJOA score increased by(3.6±2.4)points at the time of optimal neurological recovery postoperatively,and the NDI decreased by(4.8±7.3)％.At the last follow-up,compared to the time of optimal neurological recovery,the mJOA score decreased by(0.6±2.1)points,and the NDI increased by(0.8±2.7)％.At the time of optimal neurological recovery postoperatively,the improvement in mJOA score was 62.5％in the severe compression group,which was comparable to the 64.2％in the compression group(P=0.757).At the last follow-up,the cervical lordosis angle decreased from 14.4°±10.2° preoperatively to 12.1°±11.6°,but the difference was not statistically significant(P=0.087).There was no statistically significant difference in the incidence of postoperative complications between the two groups(all P＞0.05).Conclusions:SLAC can effectively improve neurological function in patients with multisegmental severe cervical OPLL and maintain long-term efficacy and cervical lordosis.Comparable satisfactory outcomes can be achieved in patients with severe compression.
LaminoplastyOssification of the Posterior Longitudinal LigamentSevere CompressionLong-term Follow-up
NETL
NSTL
万方数据
