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Comparative Analysis of Postoperative Sagittal Balance in Expansive Open-Door Laminoplasty versus Laminectomy with Fusion for Multilevel Ossification of Posterior Longitudinal Ligament: A Retrospective Study.
Ma, Xudong; Yu, Zhen; Wu, Duoyue; Huang, Yan.
Affiliation
  • Ma X; Department of Spinal Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (mainland).
  • Yu Z; The Graduate School of Bengbu Medical College, Bengbu, Anhui, China (mainland).
  • Wu D; Department of Orthopedic Surgery, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (mainland).
  • Huang Y; Department of Orthopedic Surgery, Fuyang Sixth People's Hospital, Fuyang, Anhui, China (mainland).
Med Sci Monit ; 30: e943057, 2024 May 15.
Article in En | MEDLINE | ID: mdl-38745408
ABSTRACT
BACKGROUND This single-center study included 80 patients with multilevel cervical ossification of the posterior longitudinal ligament (OPLL) and aimed to compare postoperative sagittal balance following treatment with expansive open-door laminoplasty (LP) vs total laminectomy with fusion (LF). MATERIAL AND METHODS Data of 80 patients with multilevel OPLL treated with LP vs LF between January 2017 and January 2022 were retrospectively analyzed. The basic data, cervical sagittal parameters, and clinical outcomes of the patients were counted in the preoperative and postoperative periods, and complications were recorded. Forty patients underwent LP and 40 underwent LF. Cervical sagittal parameters were compared between and within the 2 groups. Clinical outcomes and complications were compared between the 2 groups. RESULTS At last follow-up, the postoperative C2-C7 Cobb angel, T1 slope (T1S), and C7 slope (C7S) were significantly higher in the LF group than in the LP group (P<0.001). C2-C7 SVA (cSVA) was slightly higher in the LF group (P>0.05) and significantly higher in the LP group (P<0.05). The incidence of postoperative complications in the LP group was significantly lower than in the LF group (P=0.02). The postoperative scores on the Visual Analog Scale (VAS), Neck Disability Index (NDI), and Japanese Orthopedic Association (JOA) were significantly improved in both groups (P<0.001). CONCLUSIONS Both procedures had good outcomes in neurological improvement. After posterior surgery, the cervical vertebrae all showed a tilting forward. Compared to LP, LF may change cervical balance in Cobb angel, T1S. LF has better efficacy in improving cervical lordosis compared with LP. Patients with high T1 slope after surgery may has more axial pain.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Spinal Fusion / Cervical Vertebrae / Ossification of Posterior Longitudinal Ligament / Laminoplasty / Laminectomy Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Med Sci Monit Journal subject: MEDICINA Year: 2024 Type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Spinal Fusion / Cervical Vertebrae / Ossification of Posterior Longitudinal Ligament / Laminoplasty / Laminectomy Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Med Sci Monit Journal subject: MEDICINA Year: 2024 Type: Article