Abstract
Background: Ossification of the posterior longitudinal ligament (OPLL) is a chronically progressive disease of ectopic enchondral and membranous ossification of posterior longitudinal ligament (PLL). Controversy still persists over the superiority of various surgical approaches for cervical OPLL management. Purpose: To see the efficacy of expansive laminoplasty for the management of continuous and mixed type of cervical OPLL retrospectively. Methods: Records of 20 male and 8 female aged 36-72 years (mean, 56.64 years), who underwent surgical treatment posteriorly for continuous and mixed type OPLL by laminoplasty were obtained from the year 2004 - 2020. Clinical features along with imaging studies, which included X -ray/CT /MRI, were done for the diagnosis of OPLL. Multiple variables were studied, including demographics, surgical parameters, complications and functional outcomes. Results: They were followed on an average of 59.86 ± 20.95 months (range, 24 -108 months). The average operative duration was 95 ± 15.52 min (range: 70 - 140), and the intraoperative blood loss was 199.29 ± 33.55 ml. The cervical curvature index reduced to 8.81 ± 1.96 from 11.00 ± 2.49 and the VAS score decreased from 4.25 ± 0.75 to 2.43 ± 1.40. mJOA score improved from 8.64 ± 1.03 to 13.96 ± 1.26 on the last follow-up after surgery (p < 0.01), with average recovery rate of 65.5 %. Conclusions: The management for cervical myelopathy with multilevel stenosis due to continuous and mixed type of OPLL by Laminoplasty is safe and effective.
Highlights
OPLL is a chronically progressive disease of ectopic enchondral and membranous ossification of posterior longitudinal ligament (PLL), of unknown etiology [1]
The management of cervical OPLL has been described by various surgical approaches, but continues to be controversial
The main aim of this study was to evaluate the clinical outcomes of 28 patients with continuous and mixed type of cervical OPLL following expansive laminoplasty
Summary
OPLL is a chronically progressive disease of ectopic enchondral and membranous ossification of posterior longitudinal ligament (PLL), of unknown etiology [1]. Once called ‘Japanese disease’, it’s one of the key reasons of cervical myelopathy and /or radiculopathy It was first described in 1960 by Tsukimato a Japanese scholar, where hypervascular fibrosis of PLL resulted in focal area of calcifications, periosteal cartilaginous proliferations and ossifications [2]. The main aim of this study was to evaluate the clinical outcomes of 28 patients with continuous and mixed type of cervical OPLL following expansive laminoplasty. Conclusions: The management for cervical myelopathy with multilevel stenosis due to continuous and mixed type of OPLL by Laminoplasty is safe and effective.
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