title: Laminoplasty versus conservative treatment for acute cervical spinal cord injury caused by ossification of the posterior longitudinal ligament after minor trauma.
abstract: BACKGROUND
  No reports to date have accurately evaluated the management for acute spinal cord injury (SCI) caused by ossification of the posterior longitudinal ligament (OPLL) after minor trauma.
  
  
  OBJECTIVE
  To assess whether outcomes of laminoplasty is better than conservative treatment.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  Thirty-one patients underwent surgery (L group) and 29 patients underwent conservative treatment (C group).
  
  
  METHODS
  Disability, muscle strength, sensation, and general health status.
  
  
  METHODS
  Patients were managed according to routine clinical practice and the results between groups were compared. Clinical and radiographic outcomes were assessed at admission, discharge, 6 months and at the final visit. Causes for trauma, duration of hospital stay, and complication were also evaluated.
  
  
  RESULTS
  Causes for trauma included falling, traffic accidents and sports. Mixed and segmental types were the most frequent cause of OPLL resulting into SCI. Duration of hospital stay and complications were less in the L group. Motor and sensory scores increased in the L group at discharge (p<.05) and at 6 months (p<.05), and maintained thereafter (p>.05); scores improved significantly in the C group at 6 months (p<.05), with a slight deterioration with time (p>.05); scores in the L group were higher than in the C group at each time point after surgery (p<.05). Bodily pain and mental health in SF-36 improved at discharge in the L group (p<.05); all scores improved at 6 months in both the groups (p<.05), with better improvements in the L group (p<.05). The canal diameter increased and occupation ratio decreased in the L group (p<.05), and maintained thereafter (p<.05); a slight increase of occupation ratio was observed in the C group (p>.05). Lordotic angle and range of motion were maintained in both the groups, with no significance between groups (p>.05). High-signal intensity decreased at 6 months (p<.05) in the L group; no significant change was found in the C group during the follow-up (p>.05); Significant difference was detected between the groups at 6 months and at the final visit (p<.05).
  
  
  CONCLUSIONS
  Most of the OPLL patients displayed as incomplete SCI after minor trauma. Although spontaneous improvement of SCI without surgery is often observed, laminoplasty has more satisfactory outcomes, prevents late compression of cord, and reduces perioperative complications, although with no significant benefit in cervical alignment and range of motion.
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188 Shizi St, Suzhou 215006, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188 Shizi St, Suzhou 215006, China. Electronic address: sixiu_01@163.com.
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188 Shizi St, Suzhou 215006, China.
authors.forename: Ren-Bin
authors.initials: RB
authors.lastname: Dong
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188 Shizi St, Suzhou 215006, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Feng
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188 Shizi St, Suzhou 215006, China.
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, No 188 Shizi St, Suzhou 215006, China.
authors.forename: Tian-Si
authors.initials: TS
authors.lastname: Tang
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D000208:Acute Disease; D000368:Aged; D001265:Athletic Injuries / Q000150:complications; D020210:Central Cord Syndrome / Q000150:complications / Q000209:etiology / Q000628:therapy; D002574:Cervical Vertebrae / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000209:etiology / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
keywords: Acute cervical spinal cord injury; Conservative treatment; Laminoplasty; Ossification of the posterior longitudinal ligament