Are clinical outcomes affected by laminoplasty method and K-line in patients with cervical ossification of posterior longitudinal ligament? A multicenter study

• Published in: Journal of orthopaedic surgery and research 2022-11, Vol.17 (1), p.513-513, Article 513
• Main Authors: Li, Nan, Ma, Sai, Duan, Fangfang, Wei, Yi, He, Da, Nagoshi, Narihito, Watanabe, Kota, Nakamura, Masaya, Matsumoto, Morio, Jeon, Hyeongseok, Lee, J J, Kim, Keung-Nyun, Ha, Yoon, Kwan, Kenny, Cheung, A K P, Clark, Aaron
• Format: Article
• Language: English
• Subjects: Blood; Body mass index; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Clinical outcomes; Comparative analysis; Doors; French-door; Humans; K-line; Laminoplasty; Laminoplasty - methods; Ligaments; Longitudinal Ligaments - surgery; Methods; Open-door; Orthopedics; Ossification; Ossification of Posterior Longitudinal Ligament - complications; Ossification of Posterior Longitudinal Ligament - diagnostic imaging; Ossification of Posterior Longitudinal Ligament - surgery; Ossification of the posterior longitudinal ligament; Osteogenesis; Paralysis; Regression analysis; Retrospective Studies; Spinal cord; Statistical analysis; Trauma; Treatment Outcome
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-022-03407-8

Open-door laminoplasty (ODL) and French-door laminoplasty (FDL) are the main laminoplasty techniques used to treat cervical ossification of the posterior longitudinal ligament (C-OPLL). However, few studies have compared the outcomes of ODL and modified FDL (mFDL) for C-OPLL. We explored the differences in outcomes between ODL and mFDL for C-OPLL and analyzed the technical efficacy of each procedure in patients with K-line (+) or (-) C-OPLL. From January 2010 to December 2015, 202 patients with K-line (+) or (-) C-OPLL were retrospectively recruited from 4 institutions. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score, JOA score recovery rate, operative time, blood loss, and complications. Univariate analysis and binary logistic regression models were adjusted for confounding factors. Two hundred patients (mFDL, n = 69; ODL, n = 131) with a median follow-up of 42 months (range 36-54 months) were included. The postoperative JOA score significantly improved in both groups (P  0.05). The stratified analysis of the K-line status showed more blood loss in K-line (+) patients who underwent mFDL, but there was no significant difference in the postoperative JOA score, JOA score recovery rate, or operative time between the ODL and mFDL groups. Additionally, there was no significant difference in blood loss, postoperative JOA score, JOA score recovery rate, or operative time among all patients with K-line (+) or (-) C-OPLL in both groups. Both ODL and mFDL are effective for patients with C-OPLL. However, more blood loss tends to occur during mFDL. This study showed no significant difference in the operative time or incidence of complications between the two techniques. The efficacy of ODL and mFDL was not affected by the K-line status (+ or -) in patients with C-OPLL.