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  • Laminoplasty for Multilevel Spondylotic Myelopathy and Ossification of the Posterior Longitudinal Ligament:Effects on Cervical Alignment, Spinal Cord Compression, Range of Motion, Clinical Outcome

    Final Number:
    1292

    Authors:
    Dong Wuk Son; Geun Sung Song

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Cervical open-door laminoplasty is commonly used for multiple level CSM or OPLL. We reviewed our experiences of cervical alignment changes, cord compressions, ROM and assessed outcomes of cervical open-door laminoplasty to compare with patients with OPLL versus those with CSM

    Methods: A retrospective study of the short term result in patients who had open-door laminoplasty for cervical myelopathy caused by OPLL and / or CSM was performed. From January 2009 to December 2014, total 44patients underwent open-door laminoplasty at the single medical center; 28 patients had OPLL and 16 patients had CSM. Clinical outcomes were measured using the mJOA scale. Radiologic outcomes included assessment of changes of C2 – 7 Cobb angle in the neutral and flexion-extension at perioperative and final follow-up.

    Results: The mean mJOA score dramatically improved in both the OPLL and the CSM groups. The CSM group had more improved cases, but this improvement did not reach the minimum clinically difference. In OPLL group, C2-7 cobb angle changed -10.2 to -8.2 (p<0.01) and in CSM group, C2-7 cobb angle changed -10.4 to -6.4 (p<0.01). Both results suggest kyphotic deformity is occurred on post operational alignment, but there is no clinical difference between OPLL & CSM group There was definite change on cord compression grade in both the CSM and the OPLL groups. The OPLL group had more improved case, but this improvement did not mean those are clinically different (P=0.55). Most cases showed decreased ROM. there is no clinical difference on ROM preservation (p=0.64)

    Conclusions: Similar clinical and radiologic results were investigated CSM group and OPLL group by this study. We conclude that cervical open-door laminoplasty also assures good clinical outcomes for both multiple level cervical spondylotic myelopathy and ossified posterior longitudinal ligament. Laminoplasty may limit ROM and aggravate kyphotic change in both CSM and OPLL group

    Patient Care: . We conclude that cervical open-door laminoplasty also assures good clinical outcomes for both multiple level cervical spondylotic myelopathy and ossified posterior longitudinal ligament. Laminoplasty may limit ROM and aggravate kyphotic change in both CSM and OPLL group

    Learning Objectives: We conclude that cervical open-door laminoplasty also assures good clinical outcomes for both multiple level cervical spondylotic myelopathy and ossified posterior longitudinal ligament

    References:

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