Laser-assisted anterior cervical corpectomy versus posterior laminoplasty for cervical myelopathic patients with multilevel ossification of the posterior longitudinal ligament.
OBJECTIVE
This study reports on the comparative results of a series of patients with multilevel cervical ossification of the posterior longitudinal ligament (OPLL) who were treated with laser-assisted anterior corpectomy or laminoplasty.


METHODS
Forty-eight patients (21 patients with anterior corpectomy and 27 patients with laminoplasty) with cervical OPLL involvement of three or more vertebral bodies were retrospectively reviewed. Both pre- and postoperatively neurological status was graded according to the Nurick grading system. The anteroposterior (AP) diameter change at the narrowest part of the spinal canal, the change in the regional and the overall cervical Cobb's angle, and the change in cervical range of motion (ROM) were all measured. The mean follow-up periods were 21.8 mo and 29.1 mo for the corpectomy and laminoplasty patients, respectively.


RESULTS
The mean changes in the pre- to postoperative Nurick grades were 1.9 for the corpectomy group and 1 for the laminoplasty group (p < 0.05). The mean changes in the pre- to postoperative spinal canal AP diameters were 9.1 mm and 4.11 mm, respectively, for the corpectomy group and the laminoplasty group (p < 0.05). The mean changes of the regional Cobb's angle were 1.7 degrees and -3.1 degrees (p = 0.06), and the mean changes of the overall cervical Cobb's angle were 1.1 degrees and -1.6 degrees , respectively, for the corpectomy group and the laminoplasty group (p > 0.05). The changes in the cervical degree of ROM were -19.6 degrees and -19.7 degrees , respectively, for the corpectomy group and the laminoplasty group (p > 0.05).


CONCLUSIONS
Direct decompression of the spinal cord by laser-assisted anterior cervical corpectomy was shown to be a better surgical option on long-term follow-up, yielding more recovery of neurological deficits, achieving adequate decompression of the spinal canal, and preventing the development of regional kyphosis at the operated level of the spine, in patients with multilevel cervical OPLL.
Lee
Sang-Ho
SH
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, South Korea. shlee@wooridul.co.kr
Ahn
Yong
Y
Lee
June Ho
JH
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007796:Laminectomy; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*