A retrospective imaging study of surgical outcomes and range of motion in patients with cervical ossification of the posterior longitudinal ligament
A retrospective imaging study of surgical outcomes and range of motion in patients with cervical ossification of the posterior longitudinal ligament
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DOI：
10.1007/s00586-017-5246-9
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发表时间：
2018-06-01
影响因子：
2.8
通讯作者：
Kato, Fumihiko
中科院分区：
文献类型：
--
作者：
Kanbara, Shunsuke;Imagama, Shiro;Kato, Fumihiko
目的在既往研究中引入了K线，但未将颈椎活动度（ROM）作为评价颈椎后纵韧带骨化症（OPLL）患者手术疗效的参数，很少有报道同时使用K线和X线对颈椎ROM进行评估来描述此类患者的手术效果。对100名根据K线分类的颈椎OPLL患者进行了C7椎板成形术[86名患者，K线（+）和14名患者，K线（-）]。术前和术后1年日本骨科协会（乔亚）评分用于评价恢复率。使用Cobb方法测量术前和术后C2-C7脊柱前凸角度。结果K线（+）组和K线（-）组的平均乔亚评分恢复率分别为57.3%和37.7（p < 0.05），相应的平均术后C2-C7脊柱前凸角分别为9.1A度和-3.4A度（p < 0.001）。在K线（+）组中，术后屈曲值> 0的乔亚评分恢复率显著低于术后屈曲值0的恢复率，术后1年信号强度增加等级为2或3。
Purpose The K line was introduced in a previous study, but did not include the cervical range of motion (ROM) as a parameter for evaluating surgical outcomes for patients with cervical ossification of the posterior longitudinal ligament (OPLL), and few reports have used both the K line and X-ray evaluations of the cervical ROM to describe the surgical outcomes in such patients.Methods Double-door C2-C7 or C3-C7 laminoplasty was performed in 100 patients with cervical OPLL who were classified according to the K line [86 patients, K line (+) and 14 patients, K line (-)]. Preoperative and 1-year postoperative Japanese Orthopedic Association (JOA) scores were used to evaluate recovery rates. Preoperative and postoperative C2-C7 lordotic angles were measured using the Cobb method. In addition, preoperative and postoperative sagittal alignments in flexion and extension were studied, and the flexion values were calculated by subtracting the preoperative and postoperative flexion ROM from extension ROM.Results The mean JOA scores recovery rate were 57.3% in the K line (+) and 37.7% in the K line (-) groups (p < 0.05), and the respective corresponding mean postoperative C2-C7 lordotic angles were 9.1A degrees and -3.4A degrees (p < 0.001). In the K line (+) group, the JOA score recovery rate for a postoperative flexion value > 0 was significantly lower than that for a postoperative flexion value 0 and the 1-year postoperative increased signal intensity grade was 2 or 3.