Segmental motion at the peak of the ossification foci is independent risk factor except for mal-alignment and thick ossification foci for poor outcome after laminoplasty for cervical ossification of the posterior longitudinal ligament: analyses in patients with positive K-line, lordotic alignment, and lower canal occupying ratio

Journal of Orthopaedic Surgery and Research

Yoshikazu Ikeda¹  Fumitake Nakajima¹  Mitsuhiro Hashimoto¹  Takeo Furuya²  Satoshi Maki²  Takuya Miyamoto²  Kazuhide Inage²  Yasushi Ijima²  Mitsuhiro Kitamura²  Junya Saito²  Sumihisa Orita²  Seiji Ohtori²  Takayuki Fujiyoshi³  Fumio Hasue³  Koshiro Kamiya³  Hiroshi Takahashi⁴  Masashi Yamazaki⁵  Masao Koda⁵  Hiroshi Noguchi⁵ 

[1] Department of Orthopedic Surgery, Chiba Rosai Hospital, 2-16, Tatsumidaihigashi, Ichihara, 290-0003, Chiba, Japan;Department of Orthopedic Surgery, Chiba University School of Medicine, 1-8-1 Inohana Chuou-ku Chiba City, 260-8670, Chiba, Japan;Department of Orthopedic Surgery, Kimitsu Chuo Hospital, 1010, Sakurai, Kisarazu, 292-8535, Chiba, Japan;Department of Orthopedic Surgery, Toho University Chiba Medical Center, 564-1, Shimoshizu, Sakura, 285-8741, Chiba, Japan;Department of Orthopedic Surgery, University of Tsukuba, Tennodai, 305-8575, Tsukuba, Ibaraki, Japan;

关键词: Ossification of the posterior longitudinal ligament;    K-line;    Laminoplasty;    Risk factor;    Segmental range of motion;   

DOI  :  10.1186/s13018-020-01903-3

来源: Springer

【 摘 要 】

PurposeTo elucidate the independent preoperative factors that have a significant impact on poor surgical outcome after laminoplasty for K-line (+) ossification of the posterior longitudinal ligament (OPLL). Analyses in K-line (+) patient population can exclude the influence by mal-alignment and thick OPLL, both of which are well known two major factors that have significant impact on clinical outcome.MethodsThe present study included 72 patients (50 male and 22 female) who underwent laminoplasty for K-line (+) cervical OPLL and were followed-up for at least 1 year. Recovery of Japanese Orthopedic Association score (JOA score) for cervical myelopathy was used as the measure of clinical outcome. For radiographic assessment, the type of OPLL, the maximum OPLL occupation ratio, the C2-C7 angle, and the segmental range of motion at the peak of OPLL (segmental ROM) were assessed. To elucidate the factors that are significantly associated with a poor clinical outcome after laminoplasty for K-line (+) OPLL, statistical analyses were conducted.ResultsThe mean preoperative JOA score was 8.9 points and improved to 12.8 points after surgery. The recovery of JOA score was 47 ± 35%. Stepwise logistic regression following univariate analyses revealed that preoperative segmental ROM at the peak of OPLL is an independent factor associated with a poor outcome (p = 0.04, odds ratio = 1.15).ConclusionsLarge preoperative segmental ROM at the peak of the OPLL is an independent factor that has significant impact on poor surgical outcome after laminoplasty for K-line (+) OPLL.

【 授权许可】

CC BY