Long-term outcome of laminectomy and instrumented fusion for cervical ossification of the posterior longitudinal ligament.
Between January 2000 and December 2003, a total of 83 patients (64 men and 19 women, average age: 56.4 years, range: 42-78 years) who underwent posterior laminectomy and instrumented fusion for ossification of the posterior longitudinal ligament (OPLL) were included in this study to investigate the long-term outcome of this surgical option and clarify which factors affect the prognosis. After an average 4.8-year follow-up, the mean Japanese Orthopaedic Association (JOA) score significantly increased from 9.2 +/- 1.3 points before operation to 14.2 +/- 0.9 points at the latest follow-up (P < 0.01). The improvement rate (IR) of neurological function ranged from 11.1 to 87.5%, with a mean of 62.4 +/- 13.2%. Among 83 patients, 59 (71.1%) patients had a good prognosis (IR > or = 50%), and the other 24 (28.9%) patients had a poor prognosis (IR < 50%). Postoperative nerve root palsy was the main complication in this series. Radiographic study showed that whilst improving cervical lordosis could provide a better decompression effect and good prognosis, it could have simultaneously contributed to the high incidence of postoperative nerve root palsy.
Chen
Yu
Y
Department of Orthopaedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Guo
Yongfei
Y
Chen
Deyu
D
Wang
Xinwei
X
Lu
Xuhua
X
Yuan
Wen
W
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010243:Paralysis / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013126:Spinal Nerve Roots / Q000503:physiopathology; D016896:Treatment Outcome