Cervical curvature, spinal cord MRIT2 signal, and occupying ratio impact surgical approach selection in patients with ossification of the posterior longitudinal ligament.
Eur Spine J
; 22(7): 1480-8, 2013 Jul.
Article
en En
| MEDLINE
| ID: mdl-23404355
ABSTRACT
OBJECTIVE:
Factors impacting surgical options and outcomes in patients with cervical ossification of the posterior longitudinal ligament (OPLL) were explored.METHODS:
A retrospective analysis was conducted of 127 eligible cervical OPLL patients (61 males, 66 females) aged 41-70 years (mean 55.2 years) selected from 152 total OPLL patients treated from 2002 to 2006, with 5-10-year (mean 6.8 years) follow-up. Patients underwent anterior subtotal corpectomy with ossification ligament resection (anterior surgery, n = 68) or posterior cervical double-door laminoplasty (posterior surgery, n = 59). Radiographic assessments of cervical curvature, T2-weighted MRI (MRIT2) signal, and OPLL occupying ratio were correlated with surgical strategy before surgery and at 1, 5 weeks, and 5 years.RESULTS:
Lordosis increased following anterior surgery, though kyphosis improved by 10.3 %. The canal stenosis occupying ratio was >50 %, and short-term improvement following anterior surgery was significantly higher than posterior surgery (P > 0.0001). Superior neurological function was observed in patients with unchanged versus high spinal MRIT2 signals (P = 0.0434). No significant differences were observed in short-term outcomes between anterior and posterior surgeries in high spinal MRIT2 signal patients, but anterior surgery produced significantly better long-term outcomes at 1 week (P = 0.7564) and 1 year (P = 0.0071). Complications occurred in five anterior and three posterior surgeries.CONCLUSION:
Preoperative assessment of cervical curvature, MRIT2 signal, and occupying ratio can be used to guide clinical surgical approach selection to potentially produce better long-term outcomes in patients with OPLL.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vértebras Cervicales
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Osificación del Ligamento Longitudinal Posterior
/
Procedimientos Ortopédicos
Tipo de estudio:
Observational_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur Spine J
Asunto de la revista:
ORTOPEDIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
China