A Modified Laminoplasty Technique to Treat Cervical Myelopathy Secondary to Ossification of the Posterior Longitudinal Ligament (OPLL)
Jy Jia, Wc Chen, Libiao Xu, Tianlong Wu, Xigao Cheng
Department of Orthopaedics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland)
Med Sci Monit 2017; 23:4855-4864
This study aimed to evaluate the validity of modified laminoplasty in treating close-base OPLL with an occupying ratio of more than 60%.
MATERIAL AND METHODS: Forty-seven close-base OPLL patients with an occupying ratio of more than 60% were treated through modified laminoplasty (N=22) and combined anterior-posterior approach (N=25) in the study, including 17 females and 30 males, with a mean age of 60.59±6.76 years (ranging from 46 to 75 years). The patients’ characteristics, the recovery rate of neurological function, length of the operation, intraoperative blood loss, hospital costs, and complications were recorded and compared between the 2 groups.
RESULTS: The recovery rate of neurological function did not demonstrate a significant difference between the 2 groups (P=0.886). However, length of the operation and intraoperative blood loss in the modified laminoplasty group were shorter than those in the combined anterior-posterior approach group (P=0.001 and P=0.023). Moreover, the mean hospital costs in the modified laminoplasty group (5166.61±123.27 USD) decreased by 33.6% compared with the combined anterior-posterior approach group (7780.12±256.73 USD). Additionally, the complications of the modified laminoplasty group were lower than in the combined anterior-posterior approach group.
CONCLUSIONS: Modified laminoplasty may be considered a safe and effective strategy for patients that have demonstrated close-base OPLL with an occupying ratio of more than 60% and who cannot endure the trauma caused by the combined anterior-posterior approach due to medical disease.
Keywords: Cervical Vertebrae, Ossification of Posterior Longitudinal Ligament