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Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

 Sung Hyun Noh  ;  Kyung Hyun Kim  ;  Jeong Yoon Park  ;  Sung Uk Kuh  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho 
 MEDICINE, Vol.99(33) : e20955, 2020-08 
Journal Title
Issue Date
Adult ; Aged ; Blood Loss, Surgical ; Cervical Vertebrae / diagnostic imaging ; Cervical Vertebrae / surgery ; Diskectomy* ; Female ; Humans ; Laminoplasty* / methods ; Length of Stay ; Longitudinal Ligaments / diagnostic imaging ; Longitudinal Ligaments / surgery ; Male ; Middle Aged ; Operative Time ; Ossification of Posterior Longitudinal Ligament / complications ; Ossification of Posterior Longitudinal Ligament / diagnostic imaging ; Ossification of Posterior Longitudinal Ligament / surgery* ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies ; Spinal Cord Diseases / diagnostic imaging ; Spinal Cord Diseases / etiology* ; Spinal Cord Diseases / surgery* ; Spinal Fusion* / methods ; Treatment Outcome
We conducted a retrospective study to compare the clinical and radiological results of anterior cervical discectomy and fusion (ACDF) and posterior laminoplasty for two-level localized ossification of the posterior longitudinal ligament (OPLL).ACDF and posterior laminoplasty are performed for localized OPLL at the disc and vertebral body levels, respectively.Eighty six patients with two-level localized OPLL who underwent surgery from January 2011 to December 2016 were retrospectively investigated (41, ACDF group; 45, laminoplasty group). Clinical outcomes were reviewed, and radiologic results such as occupying ratio (OR), space available in the spinal cord, cranial and caudal OPLL-to-disc distance (ODD)/posterior body height (PBH) ratios, segmental angle, C2-C7 Cobb angle, T1 slope, C2-C7 sagittal vertical axis (SVA), and range of motion were investigated.Patients were followed-up for an average of 42.7 ± 10.5 months. Clinical outcomes, postoperative OR, and space available in the spinal cord were significantly improved at the final follow-up in both groups. Preoperatively, the OR and cranial and caudal ODD/PBH ratios were not significantly different between the groups. Compared to pre-operative values, differences in the segmental and C2-C7 Cobb angles at the final follow-up were statistically significant for the ACDF group (P < .05). The mean operative time, bleeding volume, and the duration of hospitalization were significantly lower in the ACDF group than in the laminoplasty group (P < .05). Complications occurred in 1 ACDF case and in 5 laminoplasty cases.Both ACDF and laminoplasty provided satisfactory clinical and radiologic outcomes for two-level localized OPLL. However, ACDF was associated with a lower operation time, bleeding loss, duration of hospitalization, and complications.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
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
Noh, Sung Hyun(노성현)
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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