C2 dome-shaped sublaminar decompression combined with spinous process suspension expansive laminoplasty for the treatment of high-cervical ossification of the posterior longitudinal ligament
Objective:To analyze the efficacy of C2 dome-shaped sublaminar decompression combined with spinous process suspension single open-door laminoplasty for the treatment of high-cervical ossification of the posterior longitudinal ligament (OPLL),and to further explore the influence of the K-line on surgical outcomes. Methods:A retrospective analysis was conducted on the clinical data from patients with high-cervical OPLL who underwent C2 dome-shaped sublaminar decompression combined with spinous process suspension single open-door laminoplasty at the Second Affiliated Hospital of Harbin Medical University from January 2020 to March 2022,including 13 males and 7 females,with an mean of 54.7±7.5 (ranging 42-73) years. The preoperative and final follow-up Japanese Orthopaedic Association (JOA) scores,neck pain visual analog scale (VAS) scores and cervical curvatures were compared. Results:All patients were followed for 4 to 22 months,with a mean follow-up of 12.0±6.6 months. At the final follow-up,the JOA scores improved significantly by (72.9±7.3)％ from baseline,while the changes in neck VAS scores were not statistically significant (P>0.05). The Cobb angles of C2-7,the C2-7 sagittal vertical axis (SVA),and the T1 slope angles at the final follow-up were not significantly different from the baseline values (all P>0.05). Five patients were K-line negative and 15 patients were K-line positive preoperatively,but all patients were K-line positive at the final follow-up. There were no statistically significant differences in preoperative or final follow-up neck VAS scores and radiological indices between the K-line negative group and the K-line positive group (all P>0.05). Conclusions:C2 dome-shaped sublaminar decompression combined with spinous process suspension expansive laminoplasty is an effective surgical procedure for high-cervical OPLL. It effectively prevents damage to the posterior ligament complex of the cervical spine,especially the C2 semispinalis muscle insertion,significantly improves neurological function while preserving cervical curvature,and does not increase the incidence of axial neck pain. It has the similar therapeutic outcomes for patients with a negative preoperative K-line.
Cervical SpineOssification of the Posterior Longitudinal LigamentC2 Dome-shaped Sublaminar DecompressionSpinous Process Suspension Expansive Laminoplasty
万方数据
维普
