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

2012 ◽  
Vol 8 (1) ◽  
pp. 26 ◽  
Author(s):  
Dong Kwang Seo ◽  
Jin Hoon Park ◽  
Sang Ryong Jeon
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Posterior Longitudinal Ligament ◽  
Cervical Laminoplasty ◽  
Long Term Outcomes

Postoperative progression of ligamentum flavum ossification after posterior instrumented surgery for thoracic posterior longitudinal ligament ossification: long-term outcomes during a minimum 10-year follow-up

2021 ◽  
pp. 1-11
Keyword(s):  
Ligamentum Flavum ◽  
Posterior Longitudinal Ligament ◽  
Vertebral Compression Fractures ◽  
Long Term Outcomes ◽  
Posterior Decompression ◽  
Fusion Surgery ◽  
Fusion Level ◽  
Estimated Blood Loss

OBJECTIVE The authors sought to investigate clinical and radiological outcomes after thoracic posterior fusion surgery during a minimum of 10 years of follow-up, including postoperative progression of ossification, in patients with thoracic ossification of the posterior longitudinal ligament (T-OPLL). METHODS The study participants were 34 consecutive patients (15 men, 19 women) with an average age at surgery of 53.6 years (range 36–80 years) who underwent posterior decompression and fusion surgery with instrumentation at the authors’ hospital. The minimum follow-up period was 10 years. Estimated blood loss, operative time, pre- and postoperative Japanese Orthopaedic Association (JOA) scores, and JOA score recovery rates were investigated. Dekyphotic changes were evaluated on plain radiographs of thoracic kyphotic angles and fusion levels pre- and postoperatively and 10 years after surgery. The distal junctional angle (DJA) was measured preoperatively and at 10 years after surgery to evaluate distal junctional kyphosis (DJK). Ossification progression at distal intervertebrae was investigated on CT. RESULTS The Cobb angles at T1–12 were 46.8°, 38.7°, and 42.6°, and those at the fusion level were 39.6°, 31.1°, and 34.1° pre- and postoperatively and at 10 years after surgery, respectively. The changes in the kyphotic angles from pre- to postoperatively and to 10 years after surgery were 8.0° and 7.2° at T1–12 and 8.4° and 7.9° at the fusion level, respectively. The DJA changed from 4.5° postoperatively to 10.9° at 10 years after surgery. There were 11 patients (32.3%) with DJK during follow-up, including 4 (11.8%) with vertebral compression fractures at lower instrumented vertebrae or adjacent vertebrae. Progression of ossification of the ligamentum flavum (OLF) on the caudal side occurred in 8 cases (23.6%), but none had ossification of the posterior longitudinal ligament (OPLL) progression. Cases with OLF progression had a significantly lower rate of DJK (0% vs 38.5%, p < 0.01), a lower DJA (3.4° vs 13.2°, p < 0.01), and a smaller change in DJA at 10 years after surgery (0.8° vs 8.1°, p < 0.01). CONCLUSIONS Posterior decompression and fusion surgery with instrumentation for T-OPLL was found to be a relatively safe and stable surgical procedure based on the long-term outcomes. Progression of OLF on the caudal side occurred in 23.6% of cases, but cases with OLF progression did not have DJK. Progression of DJK shifts the load in the spinal canal forward and the load on the ligamentum flavum is decreased. This may explain the lack of ossification in cases with DJK.

COMPLAINT OF NUCHAL PAIN FOLLOWING CERVICAL LAMINOPLASTY

1999 ◽  
Vol 03 (04) ◽  
pp. 253-258 ◽  
Author(s):  
Kazuo Saita ◽  
Yuichi Hishino ◽  
Ichiro Kikkawa ◽  
Takao Ishii ◽  
Joon Hee Lee
Keyword(s):  
Blood Loss ◽  
Cervical Spondylotic Myelopathy ◽  
Influencing Factor ◽  
Operation Time ◽  
Posterior Longitudinal Ligament ◽  
Cervical Laminoplasty ◽  
Open Type ◽  
Posterior Neck ◽  
One Year ◽  
Spastic Tetraparesis

There is a report that 60% of patients suffer from neck and shoulder symptoms following unilateral open type laminoplasty. As for French-window-open type cervical laminoplasty, however, postoperative nuchal pain has not been fully investigated. The purpose of this study is to describe the prevalence and severity of nuchal pain following French-window-open type cervical laminoplasty, and to investigate the pain's influencing factor. Eighty-three cases with spastic tetraparesis due to cervical spondylotic myelopathy or ossification of posterior longitudinal ligament were followed. We interviewed these patients, at three months after surgery and again at one year after surgery, about the existence of nuchal pain, its laterality, and whether treatment was needed. Nuchal complaints remained in 56 out of 83 patients at three months and in 37 out of 78 patients at one year following surgery. There was no correlation between the complaint and disease, age, sex, blood loss, or method of muscle reconstruction. The side for which the patient complained of pain coincided with the approached side, and the magnitude of the complaint correlated with operation time. The results suggest that the cause of the nuchal pain is damage to the posterior neck muscles by retractor.

scholarly journals Long-Term Outcomes of Cervical Laminoplasty in the Elderly

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Yasushi Oshima ◽  
Kota Miyoshi ◽  
Yoji Mikami ◽  
Hideki Nakamoto ◽  
Sakae Tanaka
Keyword(s):  
Hazard Analysis ◽  
The Elderly ◽  
Neurological Status ◽  
Cervical Laminoplasty ◽  
Long Term Outcomes ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Upper And Lower Extremities

Incidences of cervical laminoplasty in the elderly are increasing; the influence of other age-related complications and neurological status must be considered for justifying surgery. This study identified the aforementioned influence on long-term outcomes of cervical laminoplasty in patients aged ≥75 years. Thirty-seven of 38 consecutive patients aged ≥75 years who underwent cervical laminoplasty were retrospectively evaluated. Minimum 5-year follow-up was acceptable if patients were complication-free. Follow-up was terminated when neurological evaluation was not possible, owing to death or other serious complications affecting activities of daily living (ADL). Postoperative neurological changes and newly developed severe complications were investigated. Postoperatively, one patient died of acute pneumonia, one remained nonambulatory owing to cerebral infarction, and 35 were ambulatory and were discharged. At a mean follow-up of 78 months, three patients died and nine developed serious complications severely affecting ADL. Of the 25 remaining patients, 23 remained ambulatory at mean follow-up of 105 months. Cox proportional hazard analysis revealed that postoperative motor upper and lower extremities JOA scores of ≤2 and ≤1, respectively, were risk factors for mortality or other severe complications. Postoperative neurological status can be maintained in the elderly if they remain complication-free. Poorer neurological status significantly affected their ADL and mortality.

Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up

2002 ◽  
Vol 96 (2) ◽  
pp. 180-189 ◽  
Author(s):  
Motoki Iwasaki ◽  
Yoshiharu Kawaguchi ◽  
Tomoatsu Kimura ◽  
Kazuo Yonenobu
Keyword(s):  
Cervical Spine ◽  
Recovery Rate ◽  
Posterior Longitudinal Ligament ◽  
Neurological Deterioration ◽  
Cervical Laminoplasty ◽  
Content Type ◽  
Younger Age ◽  
Fine Print

Object. The authors report the long-term (more than 10-year) results of cervical laminoplasty for ossification of the posterior longitudinal ligament (OPLL) of the cervical spine as well as the factors affecting long-term postoperative course. Methods. The authors reviewed data obtained in 92 patients who underwent cervical laminoplasty between 1982 and 1990. Three patients were lost to follow up, 25 patients died within 10 years of surgery, and 64 patients were followed for more than 10 years. Results were assessed using the Japanese Orthopaedic Association (JOA) scoring system for cervical myelopathy. The recovery rate was calculated using the Hirabayashi method. The mean neurological recovery rate during the first 10 years after surgery was 64%, which declined to 60% at the last follow-up examination (mean follow up 12.2 years). Late neurological deterioration occurred in eight patients (14%) from 5 to 15 years after surgery. The most frequent causes of late deterioration were degenerative lumbar disease (three patients), thoracic myelopathy secondary to ossification of the ligamentum flavum (two patients), or postoperative progression of OPLL at the operated level (two patients). Postoperative progression of the ossified lesion was noted in 70% of the patients, but only two patients (3%) were found to have related neurological deterioration. Additional cervical surgery was required in one patient (2%) because of neurological deterioration secondary to progression of the ossified ligament. The authors performed a multivariate stepwise analysis, and found that factors related to better clinical results were younger age at operation and less severe preexisting myelopathy. Younger age at operation, as well as mixed and continuous types of OPLL, was highly predictive of progression of OPLL. Postoperative progression of kyphotic deformity was observed in 8% of the patients, although it did not cause neurological deterioration. Conclusions. When the incidence of surgery-related complications and the strong possibility of postoperative growth of OPLL are taken into consideration, the authors recommend expansive and extensive laminoplasty for OPLL.

scholarly journals Single - Door Cervical Laminoplasty Using Basket Laminoplasty Device: A Case Report

2019 ◽  
Vol 7 (4) ◽  
pp. 603-605
Author(s):  
Tjokorda Gde Bagus Mahadewa ◽  
Dewa PW Wardhana ◽  
Sri Maliawan ◽  
Junichi Mizuno ◽  
I Putu Eka Widyadharma
Keyword(s):  
Patient Outcome ◽  
Case Report ◽  
Posterior Approach ◽  
Posterior Longitudinal Ligament ◽  
Cervical Canal ◽  
Special Device ◽  
Cervical Laminoplasty ◽  
Case Presentation ◽  
Canal Stenosis

BACKGROUND: The management of the cervical canal stenosis as a result of ossification of the posterior longitudinal ligament (OPLL) is still evolving. Anterior and posterior approaches are still much in demand by the surgeons. In Japan, a posterior approach is more well-known to be used as the case OPLL is often on the populace. Single-door laminoplasty technique or “Hirabayashi” often used with either autograft or allograft, with or without an additional miniplate. CASE PRESENTATION: In this case report, we would like to report the treatment of tetraparesis patients with “basket laminoplasty” using a special device with some advantages, not only providing stability of the lamina but also at the same time providing bone-graft container/basket for the benefit of the patient's bone fusion. CONCLUSION: Basket laminoplasty device is an excellent choice for cervical OPLL. We believe the use of this device is very favourable for long-term patient outcome.

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