Post-laminectomy Kyphosis in Patients with Cervical Ossification of the Posterior Longitudinal Ligament : Does It Cause Neurological Deterioration?

Overview

Journal J Korean Neurosurg Soc

Date 2008 Dec 20

PMID 19096629

Citations 11

Authors

Won-Sang Cho

Chun Kee Chung

Tae-Ahn Jahng

Hyun Jib Kim

Affiliations

Soon will be listed here.

Abstract

Objective: Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status.

Methods: We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated.

Results: The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0.002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae.

Conclusion: Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.

Citing Articles

Improved Function After Anterior Controllable Antedisplacement and Fusion for Cervical Ossification of Posterior Longitudinal Ligament: A Long-Term Follow-Up.

Shi Y, Sun K, Han L, Yan C, Wang J, Yang J Orthop Surg. 2024; 17(2):416-426.

PMID: 39579009 PMC: 11787986. DOI: 10.1111/os.14300.

Clinical comparison between simple laminectomy and laminectomy plus posterior instrumentation in surgical treatment of cervical myelopathy.

Gargiulo G, Girardo M, Rava A, Coniglio A, Cinnella P, Masse A Eur J Orthop Surg Traumatol. 2019; 29(5):975-982.

PMID: 30737557 DOI: 10.1007/s00590-019-02395-6.

Cervical Myelopathy Secondary to Combined Ossification of Ligamentum Flavum and Posterior Longitudinal Ligament-A Case Report.

Chachan S, Kasat N, Keng P Int J Spine Surg. 2018; 12(2):121-125.

PMID: 30276070 PMC: 6159386. DOI: 10.14444/5018.

Ossification of the posterior longitudinal ligament in the cervical spine: a review.

Boody B, Lendner M, Vaccaro A Int Orthop. 2018; 43(4):797-805.

PMID: 30116867 DOI: 10.1007/s00264-018-4106-5.

Cervical Laminectomy with Lateral Mass Screw Fixation in Cervical Spondylotic Myelopathy: Neurological and Sagittal Alignment Outcome: Do We Need Lateral Mass Screws at each Segment?.

Singrakhia M, Malewar N, Singrakhia S, Deshmukh S Indian J Orthop. 2017; 51(6):658-665.

PMID: 29200481 PMC: 5688858. DOI: 10.4103/ortho.IJOrtho_266_16.

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