ISSN: 1859 - 2872
Investigating some imaging features and results of cervical laminectomy, fixation and fusion for treatment of cervical stenosis due to ossification of the posterior longitudinal ligament
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Abstract
Objective: To investigate some characteristics on X-ray, computed tomography, magnetic resonance imaging and the results of cervical laminectomy, fixation and fusion to treat multilevel cervical spinal stenosis due to ossification of the posterior longitudinal ligament (OPLL). Subject and method: A retrospective review of 14 patients with OPLL of the cervical spine with myelopathy were operated by cervical laminectomy, fixation and fusion at the Department of Neurosurgery, 108 Military Central Hospital from January 2019 to January 2021. Investigate parameters: C2C7 flexion angle, spinal instability, OPLL characteristics on CT; number of narrow floors, change of spinal cord signal on MRI. The status of cervical spinal cord injury was evaluated according to the JOA scale at 3 time points: preoperative, at hospital discharge and last follow-up. Surgical outcomes were classified into: very good, good, fair, poor based on the recovery rate assessed according to Hirabayashi. Result: The mean C2C7 flexion angle was 9.19⁰ ± 11.11⁰ with 35.7% had kyphosis and 57.1% had spinal instability; 50% had negative K-line, 28.6% had double layer sign. On MRI: 92.9% had increased spinal cord signal on T2W, 7.1% decreased signal on T1W with number of stenosis level 4.21 ± 0.69 (3 ÷ 5 floors) and the most of stenosis level was C4C5 with 42.9%. There was a significant difference between the preoperative JOA score and the postoperative JOA score and the time of last follow-up (p<0.05). The JOA score improved on average 4.14 ± 1.09 points. The average recovery rate was 72.7 ± 16.4%. Bone healing was observed in 100% of patients. There were no patients with kyphosis at the time of hospital discharge and final follow-up. Conclusion: Cervical laminectomy, fixation and fusion is a safe and effective method of treating for multilevel cervical spinal stenosis due to OPLL.
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References
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