Impacts of postoperative changes of segmental mobility on neurological improvement after laminoplasty for cervical ossification of the posterior longitudinal ligament
Several studies have demonstrated that the dynamic factor at the mobile segment affects the severity of myelopathy in patients with cervical ossification of the posterior longitudinal ligament (C-OPLL), and posterior decompression supplemented with posterior instrumented fusion at the mobile segment...
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| Veröffentlicht in: | Medicine (Baltimore) 2021-08, Vol.100 (31), p.e26807-e26807 |
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| creator | Ohnishi, Atsunori Sakaura, Hironobu Akira, Yamagishi Ohwada, Tetsuo |
| description | Several studies have demonstrated that the dynamic factor at the mobile segment affects the severity of myelopathy in patients with cervical ossification of the posterior longitudinal ligament (C-OPLL), and posterior decompression supplemented with posterior instrumented fusion at the mobile segment provides good neurological improvement. However, there have been few reports of changes in range of motion at the mobile segment (segmental ROM) after laminoplasty (LP). The aim of this study was thus to retrospectively investigate changes in segmental ROM after LP and the impacts of these changes on neurological improvement in patients with C-OPLL.A total of 51 consecutive patients who underwent LP for C-OPLL since May 2010 and were followed for at least 2 years after surgery were included in this study. Neurological status was assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2-year follow-up. Segmental ROM at the responsible level for myelopathy was measured preoperatively and at 2-year follow-up using lateral flexion-extension radiographs of the cervical spine.The mean JOA score improved significantly from 10.7 points preoperatively to 13.5 points at 2 years after surgery (mean recovery rate, 45.0%). The mean segmental ROM decreased significantly from 6.5 degrees before surgery to 3.2 degrees at 2 years after surgery. In the good clinical outcome group (recovery rate of the JOA score ≥50%; n = 22), the mean segmental ROM decreased significantly from 5.8 degrees preoperatively to 3.0 degrees postoperatively. It also decreased significantly from 7.1 degrees to 3.4 degrees in the poor clinical outcome group (recovery rate of the JOA score |
| doi_str_mv | 10.1097/MD.0000000000026807 |
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However, there have been few reports of changes in range of motion at the mobile segment (segmental ROM) after laminoplasty (LP). The aim of this study was thus to retrospectively investigate changes in segmental ROM after LP and the impacts of these changes on neurological improvement in patients with C-OPLL.A total of 51 consecutive patients who underwent LP for C-OPLL since May 2010 and were followed for at least 2 years after surgery were included in this study. Neurological status was assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2-year follow-up. Segmental ROM at the responsible level for myelopathy was measured preoperatively and at 2-year follow-up using lateral flexion-extension radiographs of the cervical spine.The mean JOA score improved significantly from 10.7 points preoperatively to 13.5 points at 2 years after surgery (mean recovery rate, 45.0%). The mean segmental ROM decreased significantly from 6.5 degrees before surgery to 3.2 degrees at 2 years after surgery. In the good clinical outcome group (recovery rate of the JOA score ≥50%; n = 22), the mean segmental ROM decreased significantly from 5.8 degrees preoperatively to 3.0 degrees postoperatively. It also decreased significantly from 7.1 degrees to 3.4 degrees in the poor clinical outcome group (recovery rate of the JOA score <50%; n = 29).This study showed that segmental ROM was stabilized after LP in most patients with C-OPLL. Neither preoperative nor postoperative segmental ROM showed significant differences between the good and poor clinical outcome groups and neither a postoperative increase nor decrease of segmental ROM significantly affected the recovery rate of the JOA score.</description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000026807</identifier><identifier>PMID: 34397837</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Aged ; Cervical Vertebrae - diagnostic imaging ; Cervical Vertebrae - physiopathology ; Cervical Vertebrae - surgery ; Decompression, Surgical - adverse effects ; Decompression, Surgical - methods ; Female ; Humans ; Japan - epidemiology ; Laminoplasty - adverse effects ; Laminoplasty - methods ; Magnetic Resonance Imaging - methods ; Male ; Neurologic Examination - methods ; Neurologic Examination - statistics & numerical data ; Observational Study ; Ossification of Posterior Longitudinal Ligament - diagnosis ; Ossification of Posterior Longitudinal Ligament - physiopathology ; Ossification of Posterior Longitudinal Ligament - surgery ; Outcome Assessment, Health Care - methods ; Perioperative Period - methods ; Perioperative Period - statistics & numerical data ; Range of Motion, Articular ; Retrospective Studies ; Spinal Fusion - adverse effects ; Spinal Fusion - instrumentation ; Spinal Fusion - methods ; Tomography, X-Ray Computed - methods ; Treatment Outcome</subject><ispartof>Medicine (Baltimore), 2021-08, Vol.100 (31), p.e26807-e26807</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.</rights><rights>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4000-e91e723dee4f7cd57a530c070c82289e2c6e4efbea189ca8dec1522dfea768163</cites><orcidid>0000-0002-7210-4365</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341220/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341220/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34397837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ohnishi, Atsunori</creatorcontrib><creatorcontrib>Sakaura, Hironobu</creatorcontrib><creatorcontrib>Akira, Yamagishi</creatorcontrib><creatorcontrib>Ohwada, Tetsuo</creatorcontrib><title>Impacts of postoperative changes of segmental mobility on neurological improvement after laminoplasty for cervical ossification of the posterior longitudinal ligament</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description>Several studies have demonstrated that the dynamic factor at the mobile segment affects the severity of myelopathy in patients with cervical ossification of the posterior longitudinal ligament (C-OPLL), and posterior decompression supplemented with posterior instrumented fusion at the mobile segment provides good neurological improvement. However, there have been few reports of changes in range of motion at the mobile segment (segmental ROM) after laminoplasty (LP). The aim of this study was thus to retrospectively investigate changes in segmental ROM after LP and the impacts of these changes on neurological improvement in patients with C-OPLL.A total of 51 consecutive patients who underwent LP for C-OPLL since May 2010 and were followed for at least 2 years after surgery were included in this study. Neurological status was assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2-year follow-up. Segmental ROM at the responsible level for myelopathy was measured preoperatively and at 2-year follow-up using lateral flexion-extension radiographs of the cervical spine.The mean JOA score improved significantly from 10.7 points preoperatively to 13.5 points at 2 years after surgery (mean recovery rate, 45.0%). The mean segmental ROM decreased significantly from 6.5 degrees before surgery to 3.2 degrees at 2 years after surgery. In the good clinical outcome group (recovery rate of the JOA score ≥50%; n = 22), the mean segmental ROM decreased significantly from 5.8 degrees preoperatively to 3.0 degrees postoperatively. It also decreased significantly from 7.1 degrees to 3.4 degrees in the poor clinical outcome group (recovery rate of the JOA score <50%; n = 29).This study showed that segmental ROM was stabilized after LP in most patients with C-OPLL. Neither preoperative nor postoperative segmental ROM showed significant differences between the good and poor clinical outcome groups and neither a postoperative increase nor decrease of segmental ROM significantly affected the recovery rate of the JOA score.</description><subject>Aged</subject><subject>Cervical Vertebrae - diagnostic imaging</subject><subject>Cervical Vertebrae - physiopathology</subject><subject>Cervical Vertebrae - surgery</subject><subject>Decompression, Surgical - adverse effects</subject><subject>Decompression, Surgical - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Laminoplasty - adverse effects</subject><subject>Laminoplasty - methods</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Neurologic Examination - methods</subject><subject>Neurologic Examination - statistics & numerical data</subject><subject>Observational Study</subject><subject>Ossification of Posterior Longitudinal Ligament - diagnosis</subject><subject>Ossification of Posterior Longitudinal Ligament - physiopathology</subject><subject>Ossification of Posterior Longitudinal Ligament - surgery</subject><subject>Outcome Assessment, Health Care - methods</subject><subject>Perioperative Period - methods</subject><subject>Perioperative Period - statistics & numerical data</subject><subject>Range of Motion, Articular</subject><subject>Retrospective Studies</subject><subject>Spinal Fusion - adverse effects</subject><subject>Spinal Fusion - instrumentation</subject><subject>Spinal Fusion - methods</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Treatment Outcome</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1u1TAQhS0EopfCEyChLNmk-C-xs0FCLdBKrdi0a8vXmSQGJw62c6u-EM-Jc29bWryxNfPNOdYZhN4TfEJwIz5dnZ3gf4fWEosXaEMqVpdVU_OXaJOrVSkawY_Qmxh_YkyYoPw1OmKcNUIysUF_LsZZmxQL3xWzj8nPEHSyOyjMoKce9o0I_QhT0q4Y_dY6m-4KPxUTLME731uTG3acg9_BihW6SxAKp0c7-dnpmPHOh8JA2O1ZH6Pt8ivZrJLl0wB7bwg2Y85PvU1La6eMOtvrVfMtetVpF-Hd_X2Mbr59vT49Ly9_fL84_XJZGp4zKKEhIChrAXgnTFsJXTFssMBGUioboKYGDt0WNJGN0bIFQypK2w60qCWp2TH6fNCdl-0IrcnWQTs1BzvqcKe8tup5Z7KD6v1OScYJpTgLfLwXCP73AjGp0UYDzukJ_BIVrWrSUF7R1YsdUBNyIgG6RxuC1bphdXWm_t9wnvrw9IePMw8rzQA_ALfe5UjjL7fcQlADaJeGvV4lGlpSTAmWuMblWsHsL3TduFs</recordid><startdate>20210806</startdate><enddate>20210806</enddate><creator>Ohnishi, Atsunori</creator><creator>Sakaura, Hironobu</creator><creator>Akira, Yamagishi</creator><creator>Ohwada, Tetsuo</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7210-4365</orcidid></search><sort><creationdate>20210806</creationdate><title>Impacts of postoperative changes of segmental mobility on neurological improvement after laminoplasty for cervical ossification of the posterior longitudinal ligament</title><author>Ohnishi, Atsunori ; Sakaura, Hironobu ; Akira, Yamagishi ; Ohwada, Tetsuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4000-e91e723dee4f7cd57a530c070c82289e2c6e4efbea189ca8dec1522dfea768163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Cervical Vertebrae - diagnostic imaging</topic><topic>Cervical Vertebrae - physiopathology</topic><topic>Cervical Vertebrae - surgery</topic><topic>Decompression, Surgical - adverse effects</topic><topic>Decompression, Surgical - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Laminoplasty - adverse effects</topic><topic>Laminoplasty - methods</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Neurologic Examination - methods</topic><topic>Neurologic Examination - statistics & numerical data</topic><topic>Observational Study</topic><topic>Ossification of Posterior Longitudinal Ligament - diagnosis</topic><topic>Ossification of Posterior Longitudinal Ligament - physiopathology</topic><topic>Ossification of Posterior Longitudinal Ligament - surgery</topic><topic>Outcome Assessment, Health Care - methods</topic><topic>Perioperative Period - methods</topic><topic>Perioperative Period - statistics & numerical data</topic><topic>Range of Motion, Articular</topic><topic>Retrospective Studies</topic><topic>Spinal Fusion - adverse effects</topic><topic>Spinal Fusion - instrumentation</topic><topic>Spinal Fusion - methods</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ohnishi, Atsunori</creatorcontrib><creatorcontrib>Sakaura, Hironobu</creatorcontrib><creatorcontrib>Akira, Yamagishi</creatorcontrib><creatorcontrib>Ohwada, Tetsuo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ohnishi, Atsunori</au><au>Sakaura, Hironobu</au><au>Akira, Yamagishi</au><au>Ohwada, Tetsuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impacts of postoperative changes of segmental mobility on neurological improvement after laminoplasty for cervical ossification of the posterior longitudinal ligament</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2021-08-06</date><risdate>2021</risdate><volume>100</volume><issue>31</issue><spage>e26807</spage><epage>e26807</epage><pages>e26807-e26807</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract>Several studies have demonstrated that the dynamic factor at the mobile segment affects the severity of myelopathy in patients with cervical ossification of the posterior longitudinal ligament (C-OPLL), and posterior decompression supplemented with posterior instrumented fusion at the mobile segment provides good neurological improvement. However, there have been few reports of changes in range of motion at the mobile segment (segmental ROM) after laminoplasty (LP). The aim of this study was thus to retrospectively investigate changes in segmental ROM after LP and the impacts of these changes on neurological improvement in patients with C-OPLL.A total of 51 consecutive patients who underwent LP for C-OPLL since May 2010 and were followed for at least 2 years after surgery were included in this study. Neurological status was assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2-year follow-up. Segmental ROM at the responsible level for myelopathy was measured preoperatively and at 2-year follow-up using lateral flexion-extension radiographs of the cervical spine.The mean JOA score improved significantly from 10.7 points preoperatively to 13.5 points at 2 years after surgery (mean recovery rate, 45.0%). The mean segmental ROM decreased significantly from 6.5 degrees before surgery to 3.2 degrees at 2 years after surgery. In the good clinical outcome group (recovery rate of the JOA score ≥50%; n = 22), the mean segmental ROM decreased significantly from 5.8 degrees preoperatively to 3.0 degrees postoperatively. It also decreased significantly from 7.1 degrees to 3.4 degrees in the poor clinical outcome group (recovery rate of the JOA score <50%; n = 29).This study showed that segmental ROM was stabilized after LP in most patients with C-OPLL. Neither preoperative nor postoperative segmental ROM showed significant differences between the good and poor clinical outcome groups and neither a postoperative increase nor decrease of segmental ROM significantly affected the recovery rate of the JOA score.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>34397837</pmid><doi>10.1097/MD.0000000000026807</doi><orcidid>https://orcid.org/0000-0002-7210-4365</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; IngentaConnect Open Access Journals; PubMed Central; Directory of Open Access Journals; Alma/SFX Local Collection; EZB Electronic Journals Library; Wolters Kluwer Open Access |
| subjects | Aged Cervical Vertebrae - diagnostic imaging Cervical Vertebrae - physiopathology Cervical Vertebrae - surgery Decompression, Surgical - adverse effects Decompression, Surgical - methods Female Humans Japan - epidemiology Laminoplasty - adverse effects Laminoplasty - methods Magnetic Resonance Imaging - methods Male Neurologic Examination - methods Neurologic Examination - statistics & numerical data Observational Study Ossification of Posterior Longitudinal Ligament - diagnosis Ossification of Posterior Longitudinal Ligament - physiopathology Ossification of Posterior Longitudinal Ligament - surgery Outcome Assessment, Health Care - methods Perioperative Period - methods Perioperative Period - statistics & numerical data Range of Motion, Articular Retrospective Studies Spinal Fusion - adverse effects Spinal Fusion - instrumentation Spinal Fusion - methods Tomography, X-Ray Computed - methods Treatment Outcome |
| title | Impacts of postoperative changes of segmental mobility on neurological improvement after laminoplasty for cervical ossification of the posterior longitudinal ligament |
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