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5-year Follow-up Evaluation of Surgical Treatment for Cervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: A Prospective Comparative Study of Anterior Decompression and Fusion with Floating Method Versus Laminoplasty.
MedLine Citation:
PMID:  21540774     Owner:  NLM     Status:  Publisher    
STRUCTURED ABSTRACT: Study Design. Prospective, comparative clinical studyObjective. To compare the clinical outcome of anterior decompression and fusion with floating method and laminoplasty in the treatment of cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL).Summary of Background Data. There have been no reports that have accurately and prospectively compared surgical outcomes following anterior decompression and posterior decompression.Methods. For cervical myelopathy caused by OPLL, we performed anterior decompression and fusion with floating method (ADF) in 1997, 1999, 2001, 2003, and 2004 and French-door laminoplasty (LAMP) in 1996, 1998, 2000, and 2002 at one institution. Twenty patients in the ADF group and 22 patients in the LAMP group were evaluated for 5 years follow-up. The following criteria were evaluated: operation time, blood loss, complications, the Japanese Orthopedic Association score (C-JOA). For radiographic evaluation, canal narrowing ratio of OPLL (CNR), lordotic angle at C2-7, and postoperative progression of the ossified lesion were measured.Results. The operation time in the ADF group was longer than that in the LAMP group. The average blood loss showed no statistical difference between the two groups. Complications occurred in five cases in the ADF group, but none occurred in the LAMP group. The mean C-JOA score and the recovery rate in the ADF group were superior to those in the LAMP group, especially for cases with greater than 50% of the spinal canal compromised by OPLL or kyphotic alignment of the cervical spine, preoperatively. Postoperative progression of OPLL was observed in 5% of the ADF group and 50% of the LAMP group.Conclusion. ADF is considered especially suitable for cases with massive OPLL and preoperative kyphotic alignment of the cervical spine, although it leads to a higher incidence of surgery-related complications compared to LAMP.
Kenichiro Sakai; Atsushi Okawa; Makoto Takahashi; Yoshiyasu Arai; Shigenori Kawabata; Mitsuhiro Enomoto; Tsuyoshi Kato; Takashi Hirai; Kenichi Shinomiya
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-2
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-Ku, Tokyo, 113-8519, JAPAN.
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