Comparison of clinical outcomes between laminoplasty, posterior decompression with instrumented fusion, and anterior decompression with fusion for K-line (–) cervical ossification of the posterior longitudinal ligament

• Published in: European spine journal Vol. 25; no. 7; pp. 2294 - 2301
• Main Authors: Koda, Masao, Mochizuki, Makondo, Konishi, Hiroaki, Aiba, Atsuomi, Kadota, Ryo, Inada, Taigo, Kamiya, Koshiro, Ota, Mitsutoshi, Maki, Satoshi, Takahashi, Kazuhisa, Yamazaki, Masashi, Mannoji, Chikato, Furuya, Takeo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2016; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Decompression, Surgical - adverse effects; Decompression, Surgical - methods; Female; Humans; Laminoplasty - adverse effects; Laminoplasty - methods; Longitudinal Ligaments - diagnostic imaging; Longitudinal Ligaments - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Original Article; Ossification of Posterior Longitudinal Ligament - complications; Ossification of Posterior Longitudinal Ligament - diagnostic imaging; Ossification of Posterior Longitudinal Ligament - surgery; Radiography; Retrospective Studies; Spinal Cord Compression - diagnostic imaging; Spinal Cord Compression - etiology; Spinal Cord Compression - surgery; Spinal Fusion - adverse effects; Spinal Fusion - methods; Surgical Orthopedics; Treatment Outcome; Myelopathy; Posterior fusion; Anterior fusion; Kyphosis; OPLL; Anterior decompression; Laminoplasty; Posterior decompression; Cervical spine; Surgical outcome
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-016-4555-8

Purpose The K-line, which is a virtual line that connects the midpoints of the anteroposterior diameter of the spinal canal at C2 and C7 in a plain lateral radiogram, is a useful preoperative predictive indicator for sufficient decompression by laminoplasty (LMP) for ossification of the posterior longitudinal ligament (OPLL). K-line is defined as (+) when the peak of OPLL does not exceed the K-line, and is defined as (–) when the peak of OPLL exceeds the K-line. For patients with K-line (–) OPLL, LMP often results in poor outcome. The aim of the present study was to compare the clinical outcome of LMP, posterior decompression with instrumented fusion (PDF) and anterior decompression and fusion (ADF) for patients with K-line (–) OPLL. Methods The present study included patients who underwent surgical treatment including LMP, PDF and ADF for K-line (–) cervical OPLL. We retrospectively compared the clinical outcome of those patients in terms of Japanese Orthopedic Association score (JOA score) recovery rate. Results JOA score recovery rate was significantly higher in the ADF group compared with that in the LMP group and the PDF group. The JOA score recovery rate in the PDF group was significantly higher than that in the LMP group. Conclusions LMP should not be used for K-line (–) cervical OPLL. ADF is one of the suitable surgical treatments for K-line (–) OPLL. Both ADF and PDF are applicable for K-line (–) OPLL according to indications set by each institute and surgical decisions.