第22位。颈椎后纵韧带骨化的手术结果：一个病例系列和文献回顾

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100646

Ling Yi Li MD

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引用次数: 0

摘要

背景背景颈椎后纵韧带骨化可引起脊髓病和神经根病等症状。前路减压融合术（ADF）和椎板成形术（LAMP）是脊髓减压和稳定脊柱的常用手术选择。ADF提供直接减压，但具有更大的复杂性和更高的风险，而LAMP侵入性较小，但在严重病例中可能效果较差。正在进行的研究旨在比较这些方法并指导选择最合适的治疗方法。目的/研究设计/设置/患者样本/结果测量/方法收集的数据包括2010年至2024年间记录的脊髓型颈椎病的人口统计学特征、放射学表现和日本骨科协会（JOA）评分。将两组患者术后和末次随访的JOA评分与术前比较。术后并发症也进行了评估。进行回归分析，以确定与达到最小临床重要改善或JOA评分差异相关的因素。结果本研究分析了27例ADF （n = 18）或LAMP （n = 9）患者。两组具有相似的人口统计学特征，尽管在ADF组中节段性受累更为常见。术前JOA评分较高的ADF组，术后改善更大，但两组之间的恢复率相似。再手术和C5麻痹等并发症仅在ADF组发生，但这些差异无统计学意义。仅在LAMP组观察到手术部位感染。年龄、BMI和吸烟史等因素对MCID没有显著影响，但占位率显示出潜在影响（p = 0.0516），强调其作为手术成功的微妙预测因素的作用。结论ADF和LAMP治疗颈椎OPLL安全有效。然而，占用率较高的患者获得MCID成功的可能性降低。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

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P22. Surgical outcomes in cervical ossification of posterior longitudinal ligament: a case series and literature review

BACKGROUND CONTEXT

Cervical ossification of the posterior longitudinal ligament (OPLL) can cause symptoms such as myelopathy and radiculopathy. Anterior decompression and fusion (ADF) and laminoplasty (LAMP) are common surgical options to decompress the spinal cord and stabilize the spine. ADF provides direct decompression but is associated with greater complexity and higher risks, whereas LAMP is less invasive but may be less effective in severe cases. Ongoing research aims to compare these approaches and guide the selection of the most appropriate treatment.

PURPOSE

N/A

STUDY DESIGN/SETTING

N/A

PATIENT SAMPLE

N/A

OUTCOME MEASURES

N/A

METHODS

Data collection included demographic characteristics, radiological findings, and the Japanese Orthopaedic Association (JOA) score for cervical myelopathy recorded between 2010 and 2024. Postoperative and last follow-up JOA scores were compared with preoperative values within and between the two groups. Postoperative complications were also assessed. Regression analysis was performed to identify factors associated with achieving a minimal clinically important improvement or difference in the JOA score.

RESULTS

The study analyzed 27 patients who underwent either ADF (n = 18) or LAMP (n = 9). Both groups had comparable demographics, although segmental involvement was more common in the ADF group. Preoperative JOA scores were higher in the ADF group, and postoperative improvements were greater, but recovery rates were similar between the two groups. Complications such as reoperation and C5 palsy occurred only in the ADF group, though these differences were not statistically significant. Surgical site infections were observed exclusively in the LAMP group. Factors such as age, BMI, and smoking history did not significantly influence the MCID, but the occupying ratio showed a potential impact (p = 0.0516), underscoring its role as a nuanced predictor of surgical success.

CONCLUSIONS

Both ADF and LAMP are effective and safe treatments for cervical OPLL. However, patients with a higher occupying ratio may have a reduced likelihood of achieving MCID success.