Comparison of clinical outcomes between laminoplasty, posterior decompression with instrumented fusion, and anterior decompression with fusion for K-line (–) cervical ossification of the posterior longitudinal ligament

Koda, Masao; Mochizuki, Manabu; Konishi, Hiroaki; Aiba, Atsuomi; Kadota, Ryo; Inada, Taigo; Kamiya, Koshiro; M, Ota; Maki, Satoshi; Takahashi, Kazuhisa; Yamazaki, Masashi; Mannoji, Chikato; Furuya, Takeo

doi:10.1007/s00586-016-4555-8

Cited by 113 publications

(111 citation statements)

References 25 publications

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“…[7,9–12] Studies have shown poor clinical outcome after laminoplasty in patients with K-line (−) OPLL or thick OPLL (occupation ratio>60%). [7,11,13] However, retrospectively, we found that some of our patients with K-line (−) OPLL achieved satisfactory results after laminoplasty. In this study, the mean JOA score of the NEP group improved significantly, from 9.70 ± 2.16 before surgery to 12.50 ± 2.27 at the last follow-up ( P = .014), with a mean recovery rate of 32.71 ± 40.45%.…”

Section: Discussionmentioning

confidence: 76%

Clinical outcome of laminoplasty for cervical ossification of the posterior longitudinal ligament with K-line (−) in the neck neutral position but K-line (+) in the neck extension position

Zhang²,

Zhang³

et al. 2017

Medicine

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Patients with cervical ossification of the posterior longitudinal ligament (OPLL) who are K-line (−) are thought to have poor clinical outcomes after laminoplasty. The aim of this study is to compare the clinical results of patients with OPLL who were K-line (−) in the neck neutral position but K-line (+) in the neck extension position (NEP group) with patients with OPLL who were K-line (+) in the neck neutral position (NNP group).Retrospectively, 42 patients who underwent cervical laminoplasty for OPLL by our surgical group during 2012 and 2013 were reviewed and were followed for at least 2 years. The patients were divided into 2 groups according to K-line status. Standing plain radiographs of the cervical spine were obtained pre- and postoperatively. Cervical spine alignment parameters included the C2–7 Cobb angle and range of motion (ROM) measured on lateral radiographs. Clinical evaluation included pre- and postoperative JOA, NDI, and VAS scores.Ten patients were classified in the NEP group, and 32 patients were classified in the NNP group. Preoperatively, the OPLL involved segments were 4.10 ± 1.66 in the NEP group and 2.53 ± 1.16 in the NNP group (P = .005). The canal-occupying ratios were 58.40 ± 11.11% in the NEP group and 29.08 ± 11.38% in the NNP group (P < .001). The mean Cobb angle of both the groups had not changed significantly at the last follow-up. The mean cervical ROM of both the groups had decreased at the last follow-up. The mean JOA score of the NEP group improved significantly from 9.70 ± 2.16 to 12.50 ± 2.27 (P = .014). The mean JOA score of the NNP group improved significantly from 11.91 ± 1.69 to 14.93 ± 1.58 (P < .001). The mean JOA recovery rate was 32.71 ± 40.45% in the NEP group and 59.00 ± 33.80% in the NNP group (P = .036). The NDI scores of both groups were significantly decreased, and the VAS scores of both groups had not changed significantly at the last follow-up.Laminoplasty is a relatively effective and safe procedure for patients with K-line (−) in the neck neutral position but K-line (+) in the neck extension position. Instead of anterior surgery, we recommend laminoplasty for those patients with OPLL extending to 3 or more segments.

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Section: Discussionmentioning

confidence: 76%

Clinical outcome of laminoplasty for cervical ossification of the posterior longitudinal ligament with K-line (−) in the neck neutral position but K-line (+) in the neck extension position

Zhang²,

Zhang³

et al. 2017

Medicine

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“…Along with that unstandardized reporting for quality and satisfaction of outcomes was also a limiting factor. Recent studies have also suggested that sagittal alignment may affect surgical outcome in degenerative cervical myelopathy for different approaches [36,37]. Based on a comparative analysis of three techniques, Koda et al [36] suggested that posterior or anterior decompression and fusion but not laminoplasty may be used for K-line cervical ossification of the posterior longitudinal ligament.…”

Section: Discussionmentioning

confidence: 98%

“…Recent studies have also suggested that sagittal alignment may affect surgical outcome in degenerative cervical myelopathy for different approaches [36,37]. Based on a comparative analysis of three techniques, Koda et al [36] suggested that posterior or anterior decompression and fusion but not laminoplasty may be used for K-line cervical ossification of the posterior longitudinal ligament. The impact of preoperative sagittal alignment on postoperative outcomes in the present meta-analysis could not be assessed due to the nature of data reported by the included studies.…”

Section: Discussionmentioning

confidence: 98%

Laminectomy and fusion vs laminoplasty for multi-level cervical myelopathy: a systematic review and meta-analysis

Phan

Scherman²,

Xu³

et al. 2016

Eur Spine J

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“…Posterior decompression and segmental fusion for the peak of OPLL segment is the other possible posterior surgical procedures for cervical OPLL. We apply long fusion because postoperative progression of kyphosis can cause insufficient spinal cord decompression [24]. However, there is a possibility that segmental fusion for OPLL peak level can improve clinical outcome and inhibit progression of OPLL.…”

Section: Discussionmentioning

confidence: 97%

“…Addition of instrumented fusion could suppress the progression of OPLL, however operative time and estimated blood loss increased. Thus we apply instrumented fusion not for prophylactics of OPLL progression but for kyphosis and/or thick ossification foci [24]. Posterior decompression and segmental fusion for the peak of OPLL segment is the other possible posterior surgical procedures for cervical OPLL.…”

Section: Discussionmentioning

confidence: 99%

Addition of instrumented fusion after posterior decompression surgery suppresses thickening of ossification of the posterior longitudinal ligament of the cervical spine

Furuya

Maki

et al. 2016

Journal of Clinical Neuroscience

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Comparison of clinical outcomes between laminoplasty, posterior decompression with instrumented fusion, and anterior decompression with fusion for K-line (–) cervical ossification of the posterior longitudinal ligament

Abstract: LMP should not be used for K-line (-) cervical OPLL. ADF is one of the suitable surgical treatments for K-line (-) OPLL. Both ADF and PDF are applicable for K-line (-) OPLL according to indications set by each institute and surgical decisions.

Cited by 113 publications

References 25 publications

Clinical outcome of laminoplasty for cervical ossification of the posterior longitudinal ligament with K-line (−) in the neck neutral position but K-line (+) in the neck extension position

Clinical outcome of laminoplasty for cervical ossification of the posterior longitudinal ligament with K-line (−) in the neck neutral position but K-line (+) in the neck extension position

Laminectomy and fusion vs laminoplasty for multi-level cervical myelopathy: a systematic review and meta-analysis

Addition of instrumented fusion after posterior decompression surgery suppresses thickening of ossification of the posterior longitudinal ligament of the cervical spine

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