Segmental motion at the peak of the ossification foci is independent risk factor except for mal-alignment and thick ossification foci for poor outcome after laminoplasty for cervical ossification of the posterior longitudinal ligament: analyses in patients with positive K-line, lordotic alignment, and lower canal occupying ratio

• Published in: Journal of orthopaedic surgery and research Vol. 15; no. 1; p. 407
• Main Authors: Saito, Junya, Koda, Masao, Furuya, Takeo, Maki, Satoshi, Ijima, Yasushi, Kitamura, Mitsuhiro, Miyamoto, Takuya, Orita, Sumihisa, Inage, Kazuhide, Hasue, Fumio, Fujiyoshi, Takayuki, Kamiya, Koshiro, Ikeda, Yoshikazu, Nakajima, Fumitake, Hashimoto, Mitsuhiro, Noguchi, Hiroshi, Takahashi, Hiroshi, Yamazaki, Masashi, Ohtori, Seiji
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.09.2020; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Associations; Bone Malalignment; Central nervous system diseases; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - pathology; Cervical Vertebrae - physiopathology; Cervical Vertebrae - surgery; Clinical outcomes; Female; Follow-Up Studies; Humans; K-line; Laminoplasty; Laminoplasty - adverse effects; Laminoplasty - methods; Ligaments; Male; Medical research; Middle Aged; Orthopedics; Ossification; Ossification of Posterior Longitudinal Ligament - diagnostic imaging; Ossification of Posterior Longitudinal Ligament - pathology; Ossification of Posterior Longitudinal Ligament - physiopathology; Ossification of Posterior Longitudinal Ligament - surgery; Ossification of the posterior longitudinal ligament; Ossification, Heterotopic; Patients; Preoperative Period; Range of Motion, Articular; Risk factor; Risk Factors; Segmental range of motion; Spinal cord; Statistical analysis; Surgery; Surgical outcomes; Treatment Outcome; Segmental range of motion; Laminoplasty; Ossification of the posterior longitudinal ligament; K-line; Risk factor
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-020-01903-3

To elucidate the independent preoperative factors that have a significant impact on poor surgical outcome after laminoplasty for K-line (+) ossification of the posterior longitudinal ligament (OPLL). Analyses in K-line (+) patient population can exclude the influence by mal-alignment and thick OPLL, both of which are well known two major factors that have significant impact on clinical outcome. The present study included 72 patients (50 male and 22 female) who underwent laminoplasty for K-line (+) cervical OPLL and were followed-up for at least 1 year. Recovery of Japanese Orthopedic Association score (JOA score) for cervical myelopathy was used as the measure of clinical outcome. For radiographic assessment, the type of OPLL, the maximum OPLL occupation ratio, the C2-C7 angle, and the segmental range of motion at the peak of OPLL (segmental ROM) were assessed. To elucidate the factors that are significantly associated with a poor clinical outcome after laminoplasty for K-line (+) OPLL, statistical analyses were conducted. The mean preoperative JOA score was 8.9 points and improved to 12.8 points after surgery. The recovery of JOA score was 47 ± 35%. Stepwise logistic regression following univariate analyses revealed that preoperative segmental ROM at the peak of OPLL is an independent factor associated with a poor outcome (p = 0.04, odds ratio = 1.15). Large preoperative segmental ROM at the peak of the OPLL is an independent factor that has significant impact on poor surgical outcome after laminoplasty for K-line (+) OPLL.