7. A clinical study on the treatment of cervical OPLL with spinal endoscopic minimally invasive surgery

Abstract

BACKGROUND CONTEXT

N/A

PURPOSE

To thoroughly investigate the practical clinical outcomes and safety of using spinal endoscopic minimally invasive surgery in the treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine.

STUDY DESIGN/SETTING

A retrospective analysis

PATIENT SAMPLE

N/A

OUTCOME MEASURES

N/A

METHODS

A retrospective analysis was conducted on the clinical data of 39 patients with cervical OPLL who underwent spinal endoscopic minimally invasive surgery at our hospital from May 2022 to July 2023. Among them, 32 were male and 7 were female, with an average age of 61.8 years. There were 18 cases of single-segment surgery, 10 cases of double-segment surgery, 7 cases of triple-segment surgery, 2 cases of quadruple-segment surgery, 1 case of penta-segment surgery, and 1 case of hexa-segment surgery. Surgeries involving two or fewer segments were performed under local anesthesia, while surgeries involving three or more segments were performed under general anesthesia. Operation time, intraoperative blood loss, hospitalization time, and other indicators were recorded. The preoperative and postoperative symptoms, imaging features, Japanese Orthopaedic Association (JOA) score, visual analog score (VAS) score for pain, neck disability index (NDI) score for cervical dysfunction were recorded to evaluate the improvement of neurological function and recovery of cervical function before and after surgery. The occurrence of postoperative complications was also observed.

RESULTS

A total of 31 patients underwent local anesthesia and 8 patients underwent general anesthesia. Three patients with multiple segments underwent staged surgical treatment. The average operation time was 144.53±93.46 minutes, the average intraoperative blood loss was [32.91±20.10] milliliters, and the average hospitalization time was 7.06±3.82 days. Long-term follow-up after surgery showed that the preoperative JOA score was 10.25±2.06 points, the NDI score was 47.73±16.28 points, and the VAS score was 5.10±1.42 points. The postoperative final follow-up JOA score was 14.25±1.71 points, NDI score was 20.75±13.55 points, and VAS score was 2.36±1.65 points. There was a significant difference in these scores at different times compared to the preoperative scores. The postoperative JOA score improved significantly compared to the preoperative score, while both the NDI and VAS scores decreased significantly. Postoperative complications occurred in two patients with C5 nerve root traction symptoms, which improved within three months after surgery. Two patients had unsatisfactory postoperative symptom improvement and were recommended for further open surgical treatment, but they opted for conservative treatment instead.

CONCLUSIONS

Spine endoscopic minimally invasive surgery for the treatment of cervical OPLL has advantages such as small trauma, rapid recovery, and few complications. It can effectively improve patients' neurological function and cervical function, but it is still necessary to strictly grasp the surgical indication and further accumulate clinical experience to improve surgical effectiveness and safety. Keywords: spine endoscopy; ossification of the posterior longitudinal ligament of the cervical spine; minimally invasive surgery; cervical spondylosis.

FDA Device/Drug Status

This abstract does not discuss or include any applicable devices or drugs.