Abstract:Objective To investigate the effect of different cervical open door laminoplasty for multi-level ossification of posterior longitudinal ligament.Methods From June 2013 to June 2016,96 cases with multi-level ossification of posterior longitudinal ligament(OPLL) underwent three different methods of cervical open door laminoplasty.37 cases underwent traditional open door laminoplasty(traditional group),27 cases underwent open door laminoplasty and titanium miniplate fixation(miniplate group),and 32 cases underwent modified open door laminoplasty and lateral mass screw fixation(modified group).22 males and 15 females with a mean age of 54.3(range,34~68) years old were included in the traditional group.15 males and 12 females with a mean age of 56.2(range,36~65) years old were included in the miniplate group.19 males and 13 females with a mean age of 55.7(range,36~69) years old were included in the modified group. Patients in the modified group had multi-level OPLL and cervical instability.Operation time,intraoperative blood loss,complications,pre-and post-operative Japanese Orthopedic Association(JOA) score,pre-and post-operative neck and arm Visual Analogue Scale(VAS) score,and postoperative lamina open angle were recorded and analyzed.Results All the patients with OPLL underwent surgeries successfully.The follow-up time was 15~51 months.No significant differences in operation time and blood loss were found among the three groups(P>0.05).All patients in three groups had improved JOA scores and decreased VAS scores after surgeries(P<0.01).There were no significant differences in pre-and post-operative JOA score,improvement rate of JOA score,or VAS scores among three groups(P>0.05).The three groups had similar lamina open angles at one week postoperatively(P>0.05).At last follow-up,the traditional group had a smaller lamina open angle than the miniplate group and modified group(P<0.01).8 cases in traditional group,3 cases in miniplate group,and 4 cases in modified group suffered axial symptom after surgery.The traditional group had a high rate of axial symptom.5 cases in traditional group,3 cases in miniplate group,and 3 cases in modified group suffered C5 nerve root palsy after surgery.Conclusion All the three different methods of cervical open door laminoplasty for OPLL can result in favorable neurologic decompression.Cervical open door laminoplasty combined with titanium miniplate fixation,and modified open door laminoplasty combined with lateral mass screw fixation can result in larger lamina open angle and lower axial symptom rate.
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