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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: A retrospective observational study.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28562546
OWN - NLM
STAT- In-Process
DA  - 20170531
LR  - 20170531
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 22
DP  - 2017 Jun
TI  - 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: A retrospective observational study.
PG  - e6964
LID - 10.1097/MD.0000000000006964 [doi]
AB  - 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 &lt; .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 &lt; .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.
FAU - Li, Jun
AU  - Li J
AD  - aDepartment of Orthopedics, the Second Affiliated Hospital bDepartment of General
      Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University,
      Hangzhou, China.
FAU - Zhang, Yan
AU  - Zhang Y
FAU - Zhang, Ning
AU  - Zhang N
FAU - Xv, Zheng-Kuan
AU  - Xv ZK
FAU - Li, Hao
AU  - Li H
FAU - Chen, Gang
AU  - Chen G
FAU - Li, Fang-Cai
AU  - Li FC
FAU - Chen, Qi-Xin
AU  - Chen QX
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/06/01 06:00
MHDA- 2017/06/01 06:00
CRDT- 2017/06/01 06:00
AID - 10.1097/MD.0000000000006964 [doi]
AID - 00005792-201706020-00022 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jun;96(22):e6964. doi: 10.1097/MD.0000000000006964.

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