Abstract
Background
In multilevel ossification of the posterior longitudinal ligament (OPLL), laminectomy is an effective surgical technique; however, there is a possibility of kyphotic alignment change after surgery. Nevertheless, in the continuous type of OPLL, the ossification foci are connected and may act as stabilizers preventing alignment change. We here compare the surgical outcome of laminectomy and laminoplasty in continuous-type OPLL of the cervical spine.
Methods
Seventy-three patients who underwent cervical laminectomy or laminoplasty for continuous-type OPLL from 2004 to 2014 were enrolled. The clinical outcomes were assessed by using the neck disability index, visual analogue scale, and Japanese Orthopedic Association scoring systems. Radiological evaluation with plain lateral radiographs was performed to observe alignment changes.
Results
The perioperative clinical outcome with laminectomy did not differ significantly from that of laminoplasty. Kyphotic change was observed in 3 of 35 patients with laminectomy and 3 of 38 patients with laminoplasty. Although loss of lordosis was observed in both groups, the C2–7 Cobb angle, sagittal vertical axis (SVA), and T1 slope did not demonstrate significant statistical differences between laminectomy and laminoplasty. Moreover, the C2–7 SVA in the C7-included laminectomy group (33.9 ± 13.4) became greater than that in the C7-excluded laminectomy group (24.8 ± 11.3) at the final follow-up (p = 0.049).
Conclusions
In continuous-type OPLL, the surgical outcome did not show any significant difference between laminectomy and laminoplasty. Laminectomy alone is also a good choice in continuous-type OPLL, similar to laminoplasty.
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References
Barrey C, Jund J, Noseda O, Roussouly P (2007) Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 16:1459–1467
Breig A, el-Nadi AF (1966) Biomechanics of the cervical spinal cord. Relief of contact pressure on and overstretching of the spinal cord. Acta Radiol Diagn (Stockh) 4:602–624
Cho WS, Chung CK, Jahng TA, Kim HJ (2008) Post-laminectomy kyphosis in patients with cervical ossification of the posterior longitudinal ligament: does it cause neurological deterioration? J Korean Neurosurg Soc 43:259–264
Deutsch H, Haid RW, Rodts GE, Mummaneni PV (2003) Postlaminectomy cervical deformity. Neurosurg Focus 15:E5
Epstein NE (1994) The surgical management of ossification of the posterior longitudinal ligament in 43 north americans. Spine (Phila Pa 1976) 19:664–672
Ferch RD, Shad A, Cadoux-Hudson TA, Teddy PJ (2004) Anterior correction of cervical kyphotic deformity: effects on myelopathy, neck pain, and sagittal alignment. J Neurosurg 100:13–19
Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F (2005) The impact of positive sagittal balance in adult spinal deformity. Spine (Phila Pa 1976) 30:2024–2029
Guigui P, Benoist M, Deburge A (1998) Spinal deformity and instability after multilevel cervical laminectomy for spondylotic myelopathy. Spine (Phila Pa 1976) 23:440–447
Hirabayashi K, Miyakawa J, Satomi K, Maruyama T, Wakano K (1981) Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine (Phila Pa 1976) 6:354–364
Hirabayashi K, Satomi K (1988) Operative procedure and results of expansive open-door laminoplasty. Spine (Phila Pa 1976) 13:870–876
Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y (1983) Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine (Phila Pa 1976) 8:693–699
Hyun SJ, Riew KD, Rhim SC (2013) Range of motion loss after cervical laminoplasty: a prospective study with minimum 5-year follow-up data. Spine J 13:384–390
Ishida Y, Suzuki K, Ohmori K, Kikata Y, Hattori Y (1989) Critical analysis of extensive cervical laminectomy. Neurosurgery 24:215–222
Ishihara H, Kanamori M, Kawaguchi Y, Nakamura H, Kimura T (2004) Adjacent segment disease after anterior cervical interbody fusion. Spine J 4:624–628
Kaptain GJ, Simmons NE, Replogle RE, Pobereskin L (2000) Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. J Neurosurg 93:199–204
Kato Y, Iwasaki M, Fuji T, Yonenobu K, Ochi T (1998) Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament. J Neurosurg 89:217–223
Kawakami M, Tamaki T, Yoshida M, Hayashi N, Ando M, Yamada H (1999) Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disord 12:50–56
Lee SE, Chung CK, Jahng TA, Kim HJ (2013) Long-term outcome of laminectomy for cervical ossification of the posterior longitudinal ligament. J Neurosurg Spine 18:465–471
Masaki Y, Yamazaki M, Okawa A, Aramomi M, Hashimoto M, Koda M, Mochizuki M, Moriya H (2007) An analysis of factors causing poor surgical outcome in patients with cervical myelopathy due to ossification of the posterior longitudinal ligament: anterior decompression with spinal fusion versus laminoplasty. J Spinal Disord Tech 20:7–13
Matsunaga S, Sakou T, Nakanisi K (1999) Analysis of the cervical spine alignment following laminoplasty and laminectomy. Spinal Cord 37:20–24
Mikawa Y, Shikata J, Yamamuro T (1987) Spinal deformity and instability after multilevel cervical laminectomy. Spine (Phila Pa 1976) 12:6–11
Nolan JP Jr, Sherk HH (1988) Biomechanical evaluation of the extensor musculature of the cervical spine. Spine (Phila Pa 1976) 13:9-11
Ratliff JK, Cooper PR (2003) Cervical laminoplasty: a critical review. J Neurosurg 98:230–238
Sasso RC, Ruggiero RA Jr, Reilly TM, Hall PV (2003) Early reconstruction failures after multilevel cervical corpectomy. Spine (Phila Pa 1976) 28:140–142
Saunders RL, Pikus HJ, Ball P (1998) Four-level cervical corpectomy. Spine (Phila Pa 1976) 23:2455–2461
Tsukimoto H (1960) A case report-autopsy of syndrome of compression of spinal cord owing to ossification within spinal canal of cervical spines. Arch Jap Chir 29:1003–1007
Yuan W, Zhu Y, Liu X, Zhu H, Zhou X, Zhou R, Cui C, Li J (2015) Postoperative three-dimensional cervical range of motion and neurological outcomes in patients with cervical ossification of the posterior longitudinal ligament: cervical laminoplasty versus laminectomy with fusion. Clin Neurol Neurosurg 134:17–23
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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type study, formal consent is not required.
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Yoo, S., Ryu, D., Choi, HJ. et al. Ossification foci act as stabilizers in continuous-type ossification of the posterior longitudinal ligament: a comparative study between laminectomy and laminoplasty. Acta Neurochir 159, 1783–1790 (2017). https://doi.org/10.1007/s00701-017-3233-x
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DOI: https://doi.org/10.1007/s00701-017-3233-x