Surgical Outcomes of the Ossification of the Posterior Longitudinal Ligament According to the Involvement of the C2 Segment
Surgical Outcomes of the Ossification of the Posterior Longitudinal Ligament According to the Involvement of the C2 Segment
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DOI：
10.1016/j.wneu.2015.11.074
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发表时间：
2016-06-01
影响因子：
2
通讯作者：
Kim, Hyun-Jib
中科院分区：
文献类型：
--
作者：
Lee, Soo Eon;Jahng, Tae-Ahn;Kim, Hyun-Jib
目的：上颈椎周围结构复杂，手术治疗困难。方法：将95例颈椎后纵韧带骨化症（OPLL）患者分为C2受累（C2+组，40例）和无C2受累（C2-组，55例），分析OPLL累及C2的治疗方法，并比较其手术疗效。在C2+组中，根据C2手术进行亚组分析（C2手术+组，14例患者）。结果：所有患者均获得最短1年的随访，平均51.36个月。在C2+和C2-组中，最常见的脊髓最西侧空间位置分别为C2和C5。在C2+组中，影像学显示OPLL较长且直径增厚，但临床结局与C2-组无差异。在C2手术+组中，脊髓偏西常见于C2（50.0%），4例患者脊髓信号改变延伸至C2，差异有统计学意义。所有患者均采用后路进行C2手术，未导致不同的临床结局或手术相关并发症。一个前手术方法被认为是有风险的机会的发展complications.CONCLUSIONS：无论是C2参与OPLL和手术，包括C2不影响临床结果。后路减压术在手术相关并发症方面比前路减压术更安全有效。
OBJECTIVE: The complex structure around the upper cervical spine makes surgical treatment difficult. the present study aimed to analyze how patients with ossification of the longitudinal ligament (OPLL) involving the C2 were managed and to compare the surgical outcomes according to the C2 involvement.METHODS: Ninety-five patients with cervical OPLL who underwent surgical treatment were divided into C2 involvement (C2+ group, 40 patients) or none (C2- group, 55 patients). In the C2+ group, subanalysis was conducted to according to the C2 surgery (C2 surgery+ group, 14 patients).RESULTS: All patients had a minimum of 1 year of follow-up with a mean of 51.36 months. The most common location of the narrowest space available for the spinal cord was C2 and C5 in the C2+ and C2- groups, respectively. In the C2+ group, a longer OPLL with thickened diameter was radiographically demonstrated, but clinical outcomes were not different from the C2- group. In the C2 surgery+ group, the narrowest spinal cord was common in the C2 (50.0%), and an extension of the signal change of spinal cord to the C2 was observed in 4 patients, showing a statistical difference. C2 surgery was performed in all patients using the posterior approach and it did not result in different clinical outcomes or surgery-related complications. An anterior surgical approach was deemed risky given the chance of the development of complications.CONCLUSIONS: Both of C2 involvement from OPLL and surgery including the C2 did not affect clinical outcomes. The posterior decompressive surgery is safer and more effective than the anterior approach regarding the development of surgery-related complications.