A Novel Concept for Making Decisions Regarding the Segments of Laminoplasty for Cervical Ossification of the Posterior Longitudinal Ligament: The Drifting Angle of Spinal Cord

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-04-28 DOI:10.1016/j.wneu.2025.124019

Huajian Zhong, Leixin Wei, Chen Xu, Huiqiao Wu, Ruizhe Wang, Xinwei Wang, Yang Liu, Wen Yuan, Huajiang Chen, Xiaolong Shen

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引用次数: 0

Abstract

Background

There is currently no established index for evaluating the adequacy of the surgical area during laminoplasty. This study aims to propose a novel concept of the drifting angle of the spinal cord (DA-SC) at the cephalic and caudal junction of surgical and nonsurgical laminae during laminoplasty, and to assess its clinical relevance.

Methods

A retrospective review of clinical and radiological data was conducted on 296 patients who underwent laminoplasty. Patients were classified into four groups based on preoperative DA-SC of cephalic and caudal junction of surgical and nonsurgical laminae: Group DA-SC SS (both cephalic and caudal DA-SC were small); DA-SC LL (both cephalic and caudal DA-SC were large); DA-SC LS (cephalic DA-SC was large whereas caudal DA-SC was small); and DA-SC SL (cephalic DA-SC was small whereas caudal DA-SC was large). Clinical outcomes were recorded and analyzed before surgery, 2 months postoperatively, and at the last follow-up.

Results

Both cephalic and caudal DA-SC increased significantly following laminoplasty, patients in group DA-SC SS demonstrated superior clinical recovery rate than that of other three groups, indicating that small DA-SC is positively related with great clinical outcomes.

Conclusions

The concept of DA-SC is valuable in assisting making decisions regarding the extent of laminoplasty in patients with cervical ossification of the posterior longitudinal ligament. Reducing the DA-SC by extending the surgical area is necessary when DA-SC is large.

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后纵韧带颈椎骨化椎板成形术中决策节段的新概念：脊髓漂移角。

背景：目前还没有确定的指标来评估椎板成形术中手术面积的充分性。本研究旨在提出椎板成形术中手术和非手术椎板头尾部连接处脊髓漂移角（DA-SC）的新概念，并评估其临床意义。方法：回顾性分析296例椎板成形术患者的临床和影像学资料。根据术前手术和非手术椎板头端和尾端交界处DA-SC分为4组：DA-SC组（头端和尾端DA-SC均较小）；DA-SC LL（头端和尾端DA-SC均较大）；DA-SC LS（头侧DA-SC大，尾侧DA-SC小）；DA-SC SL（头侧DA-SC小，尾侧DA-SC大）。记录并分析术前、术后2个月及末次随访时的临床结果。结果：椎板成形术后，头侧和尾侧DA-SC均显著增加，DA-SC组患者的临床恢复率优于其他三组，提示DA-SC小与临床预后良好呈正相关。结论：DA-SC的概念在帮助C-OPLL患者决定椎板成形术的程度方面是有价值的。当DA-SC较大时，通过扩大手术面积来减少DA-SC是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS