Narihito Nagoshi1, Toshitaka Yoshii, Satoru Egawa, Kenichiro Sakai, Kazuo Kusano, Yukihiro Nakagawa, Takashi Hirai, Kanichiro Wada, Keiichi Katsumi, Kengo Fujii, Atsushi Kimura, Takeo Furuya, Tsukasa Kanchiku, Yukitaka Nagamoto, Yasushi Oshima, Hiroaki Nakashima, Kei Ando, Masahiko Takahata, Kanji Mori, Hideaki Nakajima, Kazuma Murata, Shunji Matsunaga, Takashi Kaito, Kei Yamada, Sho Kobayashi, Satoshi Kato, Tetsuro Ohba, Satoshi Inami, Shunsuke Fujibayashi, Hiroyuki Katoh, Haruo Kanno, Kota Watanabe, Shiro Imagama, Masao Koda, Yoshiharu Kawaguchi, Katsushi Takeshita, Masaya Nakamura, Morio Matsumoto, Masashi Yamazaki, Atsushi Okawa. 1. Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinjuku Ward, Tokyo, Japan Department of Orthopedic Surgery, Tokyo Medical and Dental University, Bunkyo Ward, Tokyo, Japan Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchishi, Saitama, Japan Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyodaku, Japan Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, Katsuragi-cho, Itogun, Wakayama, Japan Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, Chuo Ward, Niigata, Niigata, Japan Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chuo Ward, Chiba, Japan Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakaishi, Osaka, Japan Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine,, Showa Ward, Nagoya, Aichi, Japan Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, Japan Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Japan Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Department of Orthopedic Surgery, Imakiire General Hospital, Kagoshimashi, Japan Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Suita-shi, Osaka, Japan Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan Department of Orthopedic Surgery, University of Yamanashi, Chuo Ward, Yamanashi, Japan Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Mibu-machi, Shimotsuga-gun, Tochigi, Japan Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Sakyo-ku, Kyoto, Japan Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan Department of Orthopaedic Surgery, Tohoku University School of Medicine, Aoba Ward, Sendai, Miyagi, Japan Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Toyama, Japan Japanese Multicenter Research Organization for Ossification of the Spinal Ligament.
Abstract
STUDY DESIGN: A prospective multicenter study. OBJECTIVE: To evaluate and compare the surgical outcomes after open-door (OD) and double-door (DD) laminoplasties in subjects with cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: Although previous studies compared clinical results after OD and DD laminoplasties, they were performed at a single institution with a relatively small sample size targeting mixed pathologies, including cervical spondylotic myelopathy. METHODS: This study was performed by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. A total of 478 patients with myelopathy caused by cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for 2 years. Of these, 41 and 164 patients received OD and DD laminoplasties, respectively. Demographic information, medical history, and imaging findings were collected. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association (JOA), JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and visual analog scale (VAS) scores. RESULTS: Age, sex, symptom duration, and comorbidities were not significantly different between the groups. Segmental ossification was the most frequent in both groups. No significant differences in K-line type, canal occupying ratio, C2-C7 angles, and range of motion (ROM) were found. Both procedures reduced the cervical ROM postoperatively. A comparable frequency of perioperative complications was observed between the groups. The cervical JOA scores showed a similar improvement at 2 years postoperatively. The reduction in VAS score for neck pain was favorable in the OD group (P = 0.02), while other pain assessments did not show any significant differences between the groups. The functional outcomes assessed using the JOACMEQ presented equivalent effective rates. CONCLUSION: The results demonstrated almost comparable surgical outcomes between OD and DD laminoplasties. Laminoplasty is a valuable technique as a therapeutic option for cervical OPLL.Level of Evidence: 5.
STUDY DESIGN: A prospective multicenter study. OBJECTIVE: To evaluate and compare the surgical outcomes after open-door (OD) and double-door (DD) laminoplasties in subjects with cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: Although previous studies compared clinical results after OD and DD laminoplasties, they were performed at a single institution with a relatively small sample size targeting mixed pathologies, including cervical spondylotic myelopathy. METHODS: This study was performed by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. A total of 478 patients with myelopathy caused by cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for 2 years. Of these, 41 and 164 patients received OD and DD laminoplasties, respectively. Demographic information, medical history, and imaging findings were collected. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association (JOA), JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and visual analog scale (VAS) scores. RESULTS: Age, sex, symptom duration, and comorbidities were not significantly different between the groups. Segmental ossification was the most frequent in both groups. No significant differences in K-line type, canal occupying ratio, C2-C7 angles, and range of motion (ROM) were found. Both procedures reduced the cervical ROM postoperatively. A comparable frequency of perioperative complications was observed between the groups. The cervical JOA scores showed a similar improvement at 2 years postoperatively. The reduction in VAS score for neck pain was favorable in the OD group (P = 0.02), while other pain assessments did not show any significant differences between the groups. The functional outcomes assessed using the JOACMEQ presented equivalent effective rates. CONCLUSION: The results demonstrated almost comparable surgical outcomes between OD and DD laminoplasties. Laminoplasty is a valuable technique as a therapeutic option for cervical OPLL.Level of Evidence: 5.