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[Using tension-band laminoplasty as a management for cervical ossification of posterior longitudinal ligament].

Junwei Zhang, Shigeru Hirabayashi, Yi Hong

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Abstract

OBJECTIVE: To evaluate the effectiveness of Tension-band Laminoplasty (TBL) as a management for cervical ossification of posterior longitudinal ligament (OPLL). METHODS: Forty-six patients with cervical OPLL and undergone TBL in our department were chosen for the present study, including 33 male and 13 female. The mean age was 59 years (36 - 77 years). These OPLLs were confirmed as following types: 4 cases of single spinal level, 20 cases of continuous and 22 cases of mixed type. C(3) or/and C(2) levels were involved in 16 cases. All the patients underwent C(2 - 7) TBL, to which C(1) laminectomy was added for the cases with C(3) and/or C(2) involved. The neurological effect was evaluated by using Japanese Orthopedic Association (JOA) scoring criteria for cervical myelopathy. The anatomical effect was analyzed by comparing the pre- and post-operatively roentgenograms and MRIs. Wilcoxon's rank test was used for the statistics study. RESULTS: For 42 (91.3%) patients, the JOA scores were improved for approximately 2 points after the operation, posterior shift of the spinal cord was obtained, while the diameters of dural sleeves and spinal cords were enlarged, yet the spinal alignments were not significantly interrupted. CONCLUSIONS: TBL was proved an effective treatment for cervical OPLL and it could be expanded to include C(1) laminectomy if the spinal levels upper than C(4) were involved.

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OBJECTIVE: To evaluate the effectiveness of Tension-band Laminoplasty (TBL) as a management for cervical ossification of posterior longitudinal ligament (OPLL). METHODS: Forty-six patients with cervical OPLL and undergone TBL in our department were chosen for the present study, including 33 male and 13 female. The mean age was 59 years (36 - 77 years). These OPLLs were confirmed as following types: 4 cases of single spinal level, 20 cases of continuous and 22 cases of mixed type. C(3) or/and C(2) levels were involved in 16 cases. All the patients underwent C(2 - 7) TBL, to which C(1) laminectomy was added for the cases with C(3) and/or C(2) involved. The neurological effect was evaluated by using Japanese Orthopedic Association (JOA) scoring criteria for cervical myelopathy. The anatomical effect was analyzed by comparing the pre- and post-operatively roentgenograms and MRIs. Wilcoxon's rank test was used for the statistics study. RESULTS: For 42 (91.3%) patients, the JOA scores were improved for approximately 2 points after the operation, posterior shift of the spinal cord was obtained, while the diameters of dural sleeves and spinal cords were enlarged, yet the spinal alignments were not significantly interrupted. CONCLUSIONS: TBL was proved an effective treatment for cervical OPLL and it could be expanded to include C(1) laminectomy if the spinal levels upper than C(4) were involved.

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Available abstract

OBJECTIVE: To evaluate the effectiveness of Tension-band Laminoplasty (TBL) as a management for cervical ossification of posterior longitudinal ligament (OPLL). METHODS: Forty-six patients with cervical OPLL and undergone TBL in our department were chosen for the present study, including 33 male and 13 female. The mean age was 59 years (36 - 77 years). These OPLLs were confirmed as following types: 4 cases of single spinal level, 20 cases of continuous and 22 cases of mixed type. C(3) or/and C(2) levels were involved in 16 cases. All the patients underwent C(2 - 7) TBL, to which C(1) laminectomy was added for the cases with C(3) and/or C(2) involved. The neurological effect was evaluated by using Japanese Orthopedic Association (JOA) scoring criteria for cervical myelopathy. The anatomical effect was analyzed by comparing the pre- and post-operatively roentgenograms and MRIs. Wilcoxon's rank test was used for the statistics study. RESULTS: For 42 (91.3%) patients, the JOA scores were improved for approximately 2 points after the operation, posterior shift of the spinal cord was obtained, while the diameters of dural sleeves and spinal cords were enlarged, yet the spinal alignments were not significantly interrupted. CONCLUSIONS: TBL was proved an effective treatment for cervical OPLL and it could be expanded to include C(1) laminectomy if the spinal levels upper than C(4) were involved.

Key concepts: Medicine, Laminoplasty, Posterior longitudinal ligament, Laminectomy, Ossification, Ossification of the posterior longitudinal ligament, Myelopathy, Surgery

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