Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

• Published in: Medicine (Baltimore) 2020-08, Vol.99 (33), p.e20955-e20955
• Main Authors: Noh, Sung Hyun, Kim, Kyung Hyun, Park, Jeong Yoon, Kuh, Sung Uk, Chin, Dong Kyu, Kim, Keun Su, Cho, Yong Eun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Loss, Surgical; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Diskectomy; Female; Humans; Laminoplasty - methods; Length of Stay; Longitudinal Ligaments - diagnostic imaging; Longitudinal Ligaments - surgery; Male; Middle Aged; Observational Study; Operative Time; Ossification of Posterior Longitudinal Ligament - complications; Ossification of Posterior Longitudinal Ligament - diagnostic imaging; Ossification of Posterior Longitudinal Ligament - surgery; Postoperative Complications; Range of Motion, Articular; Retrospective Studies; Spinal Cord Diseases - diagnostic imaging; Spinal Cord Diseases - etiology; Spinal Cord Diseases - surgery; Spinal Fusion - methods; Treatment Outcome
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000020955

We conducted a retrospective study to compare the clinical and radiological results of anterior cervical discectomy and fusion (ACDF) and posterior laminoplasty for two-level localized ossification of the posterior longitudinal ligament (OPLL).ACDF and posterior laminoplasty are performed for localized OPLL at the disc and vertebral body levels, respectively.Eighty six patients with two-level localized OPLL who underwent surgery from January 2011 to December 2016 were retrospectively investigated (41, ACDF group; 45, laminoplasty group). Clinical outcomes were reviewed, and radiologic results such as occupying ratio (OR), space available in the spinal cord, cranial and caudal OPLL-to-disc distance (ODD)/posterior body height (PBH) ratios, segmental angle, C2-C7 Cobb angle, T1 slope, C2-C7 sagittal vertical axis (SVA), and range of motion were investigated.Patients were followed-up for an average of 42.7 ± 10.5 months. Clinical outcomes, postoperative OR, and space available in the spinal cord were significantly improved at the final follow-up in both groups. Preoperatively, the OR and cranial and caudal ODD/PBH ratios were not significantly different between the groups. Compared to pre-operative values, differences in the segmental and C2-C7 Cobb angles at the final follow-up were statistically significant for the ACDF group (P