Korean J Neurotrauma.  2012 Apr;8(1):26-31. 10.13004/kjnt.2012.8.1.26.

The Comparison of Clinical and Radiological Long-Term Outcomes between Ossification of Posterior Longitudinal Ligament and Cervical Spondylotic Myelopathy after Modified Midline Splitting Cervical Laminoplasty

• Seo DK
• Park JH
• Jeon SR

• KMID: 1427679
• DOI: http://doi.org/10.13004/kjnt.2012.8.1.26

Abstract

OBJECTIVE
Both of ossification of posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM) could be treated by cervical laminoplasty. In this study we compared long-term clinical and radiological outcomes in these two disease entities, treated with modified midline splitting laminoplasty (MSL).
METHODS
We retrospectively analyzed the outcomes of 21 consecutive cervical myelopathy patients (13 OPLL and 8 CSM) who underwent modified MSL between 2004 and 2008. The mean follow-up duration was 49.5 months. The clinical outcomes were evaluated by the Japanese Orthopedic Association (JOA) score and the radiologic outcomes included the change of cervical lordosis, range of motion (ROM) and spinal canal dimension.
RESULTS
The mean JOA scores of overall patient changed from 6.9 to 11.9, resulting in mean calculated recovery rates of 42.3%. The recovery rates of each group was 38.0% in the CSM group and 45.5% in the OPLL group, respectively (p=0.45). The mean cervical lordosis changed from 12.5 to 10.75 degrees in the CSM group and from 11.76 to 9.84 degrees in the OPLL group (p=0.79). The mean cervical ROM changed from 26 to 24.2 degrees in the CSM group and from 28.7 to 26.3 degrees in the OPLL group (p=0.78). The mean canal dimension changed from 201.1 to 285.0 mm2 in the CSM group and from 198.5 to 284.7 mm2 in the OPLL group (p=0.86).
CONCLUSION
In the present study, all patients showed good long-term clinical outcomes by modified MSL. No significant clinical and radiographic difference of two disease entities in the same procedure was revealed.

Keyword

Ossification of posterior longitudinal ligament; Cervical vertebrae; Myelopathy; Laminoplasty

MeSH Terms

Animals
Asian Continental Ancestry Group
Cervical Vertebrae
Female
Follow-Up Studies
Humans
Lordosis
Orthopedics
Ossification of Posterior Longitudinal Ligament
Range of Motion, Articular
Retrospective Studies
Spinal Canal
Spinal Cord Diseases

Figure

• 

  FIGURE 1. A: Intra-operative image showing the lamina inner cortex drilling which was effective for widening of spinal canal and decompression of foramen. B: The modified midline splitting laminoplasty method. Note that the ligamentum flavum was removed.

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  FIGURE 2. A: Overall lordosis was measured as A. B: The change of lordosis. CSM: cervical spondylotic myelopathy, OPLL: ossification of posterior longitudinal ligament.

• 

  FIGURE 3. A, B: The range of motion (ROM) was determined as A-B in the dynamic cervical plain X-ray images (ROM: A-B, A: Measured angle between inferior endplate of C2 and inferior endplate of C7 at cervical extension. B: Measured angle at cervical flexion). C: The change of ROM. CSM: cervical spondylotic myelopathy, OPLL: ossification of posterior longitudinal ligament.

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  FIGURE 4. A: The dimension of spinal canal was measured as the above method. B: The change of canal dimension. CSM: cervical spondylotic myelopathy, OPLL: ossification of posterior lon-gitudinal ligament.

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