title: Addition of instrumented fusion after posterior decompression surgery suppresses thickening of ossification of the posterior longitudinal ligament of the cervical spine.
abstract: Laminoplasty (LMP) is a widely accepted surgical procedure for ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Progression of OPLL can occur in the long term after LMP. The aim of the present study was to determine whether addition of the instrumented fusion, (posterior decompression with instrumented fusion [PDF]), can suppress progression of OPLL or not. The present study included 50 patients who underwent LMP (n=23) or PDF (n=27) for OPLL of the cervical spine. We performed open door laminoplasty. PDF surgery was performed by double-door laminoplasty followed by instrumented fusion. We observed the non-ossified segment of the OPLL and measured the thickness of the OPLL at the thickest segment with pre- and postoperative sagittal CT multi-planar reconstruction images. Postoperative CT scan revealed fusion of the non-ossified segment of the OPLL was obtained in 4/23 patients (17%) in the LPM group and in 23/27 patients (85%) in the PDF group, showing a significant difference between both groups (p=0.003). Progression of the thickness of the OPLL in the PDF group (-0.1±0.4mm) was significantly smaller than in the LMP group (0.6±0.7mm, p=0.0002). The proportion of patients showing the decrease in thickness of OPLL was significantly larger in the PDF group (6/27 patients; 22%) than in the LMP group (0/23 patients; 0%, p=0.05). In conclusion, PDF surgery can suppress the thickening of OPLL.
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Ota
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Furuya
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Maki
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Taigo
authors.initials: T
authors.lastname: Inada
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Koshiro
authors.initials: K
authors.lastname: Kamiya
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ijima
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Saito
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: University of Tsukuba, Tsukuba, Ibaraki Prefecture 305-8571, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Teikyo University Chiba Medical Center, Ichihara, Chiba Prefecture Anesaki, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Aramomi
authors.affiliation: Teikyo University Chiba Medical Center, Ichihara, Chiba Prefecture Anesaki, Japan.
authors.forename: Chikato
authors.initials: C
authors.lastname: Mannoji
authors.affiliation: Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 2608670, Japan. Electronic address: masaokod@gmail.com.
authors.forename: Masao
authors.initials: M
authors.lastname: Koda
mesh_terms: D000368:Aged; D016723:Bone Remodeling; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016268:Internal Fixators; D017846:Longitudinal Ligaments / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Bone remodeling; Laminoplasty; Ossification of the posterior longitudinal ligament; Posterior fusion