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Progression of Cervical Ossification of Posterior Longitudinal Ligament After Laminoplasty or Laminectomy With Posterior Fixation

 Kang, Moo Sung  ;  Kim, Kyung Hyun  ;  Park, Jeong Yoon  ;  Kuh, Sung Uk  ;  Chin, Dong Kyu  ;  Kim, Keun Su  ;  Jin, Byung Ho  ;  Cho, Yong Eun 
 CLINICAL SPINE SURGERY, Vol.32(9) : 363-368, 2019 
Journal Title
Issue Date
STUDY DESIGN: Retrospective case analysis.

OBJECTIVE: This study was conducted to investigate the course of ossification of the posterior longitudinal ligament (OPLL) progression after laminoplasty (LP) or laminectomy with posterior fixation (PF).

SUMMARY OF BACKGROUND DATA: LP is now recognized as a standard technique for the treatment of cervical multisegment OPLL; however, PF is beneficial for patients with severe stenosis. In recent years, there has been increasing interest in mechanical stress in OPLL, which is assumed to significantly impact progression.

METHODS: The progression of OPLL was assessed using midline sagittal computed tomography images of the cervical spine at various follow-up points. Radiographic parameters including the C2-C7 Cobb angle, C2-C7 range of motion (ROM), and adjacent cranial and caudal segmental ROMs were measured. Postoperative changes and differences between the LP and PF groups in the radiographic parameters were calculated to assess biomechanical stress. Logistic regression analysis was used to analyze the risk factors affecting the progression rate.

RESULTS: The authors included 14 PF and 36 LP patients, with a mean follow-up period of 28.9±20.8 and 37.6±16.8 months, respectively (P=0.069). After surgical treatment, both groups showed loss of cervical lordosis (9.2±6.9 vs. 5.3±8.2 degrees, P=0.220) and C2-C7 ROM (14.6± 13.5 vs. 13.1±12.2 degrees, P=0.861). The decrease of ROM in the cranial adjacent segment was larger in the LP group than in the PF group (0.7±4.1 vs. 1.4±5.5 degrees, P=0.453). The ROM in the caudal adjacent segment decreased in the LP group but increased in the PF group (-1.4±6.2 vs. 2.6±5.1 degrees, P=0.041). The progression rate was 2.15±1.31 mm/mo in the PF group and 1.53±1.04 mm/mo in the LP group (P=0.041). PF showed an odds ratio of 12.917 for a higher progression rate (95% confidence interval, 1.397-119.443; P=0.024).

CONCLUSION: The rate of progression of cervical OPLL was significantly higher after PF than after LP.Level III-a retrospective analysis.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Moo Sung(강무성)
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Kyung Hyun(김경현)
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
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