Influence of Spinous Process Spacers on Surgical Outcome of Laminoplasty for OPLL

Nagashima, Hideki; Nanjo, Yoshiro; Tanida, Atsushi; Mihara, Tokumitsu; Takeda, Chikako; Teshima, Ryota

doi:10.3928/01477447-20130327-29

Cited by 8 publications

(12 citation statements)

References 23 publications

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“…They advocated that the patients with a negative K-line slope, which meant the OPLL touched the spinal cord, had a significantly lower recovery rate than those with a positive K-line. In accordance with previous studies [14, 29, 30], our present study showed the better recovery rate in the patients with positive K-line than in negative K-line.…”

Section: Discussionsupporting

confidence: 93%

Prognostic factors for surgical outcome in spinal cord injury associated with ossification of the posterior longitudinal ligament (OPLL)

et al. 2015

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BackgroundOssification of the posterior longitudinal ligament (OPLL) may increase the risk of spinal cord injury (SCI) with various neurological deficits after minor trauma. However, few studies have investigated the influence of OPLL on neurological outcome after acute cord injury. We examined whether severe spinal canal stenosis caused by OPLL affects neurological outcome after SCI based on intramedullary signal intensity (SI) changes on magnetic resonance imaging (MRI).MethodsFrom June 2006 to July 2013, we treated 246 patients with cervical cord injury. Fifty-one (20.7 %) patients had ventral cord compression due to OPLL without any bony fractures. Among them, 38 patients (34 men, mean age 62.7 years) underwent cervical laminoplasty (8) and cervical decompression and fixation (30). The neurologic assessments were performed in patients who had 1-year follow-up, and the mean follow-up period was 42.2 months. OPLL type, cause of injury, cervical sagittal angle, cervical spine stenosis, cord compression ratio (space available for the spinal cord (SAC)), and grade of intramedullary SI (grade 0, none; grade 1, light; grade 2, intense T2WI) were assessed.ResultsMean American Spinal Injury Association (ASIA) motor score at admission was 38.4 ± 21.9 (range, 2–70) and improved to 67.7 ± 19.1 (range, 8–94) at last follow-up (p < 0.05). Mean recovery rate of the motor score was 55.8 ± 19.9 %. Five patients had SI grade 0, 20 patients had SI grade 1, and 13 patients had SI grade 2. Among the variables tested, age, initial ASIA motor grade, intramedullary SI grade, and SAC were significantly related to neurological outcome. However, initial cervical alignment, canal diameter, length of SI, time interval between injury and operation, and OPLL type had no significant effect on neurological outcome.ConclusionsPreoperative neurological status, cord compression ratio, and SI grade are related to neurological outcome in patients with SCI associated with OPLL. The better the preoperative neurological status, the more favorable the neurological outcome after surgery. A higher SI grade on preoperative T2WI was negatively related to neurological outcome. Therefore, the severity of SI change, cord compression ratio, and preoperative neurological status can be regarded as significant prognostic factors in patients with SCI associated with OPLL.

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Section: Discussionsupporting

confidence: 93%

Prognostic factors for surgical outcome in spinal cord injury associated with ossification of the posterior longitudinal ligament (OPLL)

et al. 2015

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“…Seven studies categorized patients into a (+) or (−) K-line group. 27,47,85,94,157,164,165 The K-line was originally described by Fujiyoshi et al as a straight line connecting the midpoints of the spinal canal at C2 and C7 on a neutral lateral radiograph. 164 A patient is classified as K-line (−) if the OPLL extends beyond the K-line and as K-line (+) if the OPLL does not (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…82 K-line (−) OPLL is associated with decreased C2-C7 range of motion and increased occupying ratio, extension/flexion ratio, and thickness. 47,164,165 Moreover, a greater percentage of patients with K-line (−) OPLL are compressed at flexion, whereas those with K-line (+) are more likely to be compressed at extension. 47…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Classification Systems for Cervical Ossification of the Posterior Longitudinal Ligament

Tetreault

Nakashima

Kato

et al. 2018

Global Spine Journal

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Design: Systematic review. Objective: To conduct a systematic review to (1) summarize various classification systems used to describe cervical ossification of the posterior longitudinal ligament (OPLL) and (2) evaluate the diagnostic accuracy of various imaging modalities and the reliability of these classification systems.Methods: A search was performed to identify studies that used a classification system to categorize patients with OPLL. Furthermore, studies were included if they reported the diagnostic accuracy of various imaging modalities or the reliability of a classification system.Results: A total of 167 studies were deemed relevant. Five classification systems were developed based on X-ray: the 9-classification system (0.60%); continuous, segmental, mixed, localized or focal, circumscribed and others (92.81%); hook, staple, bridge, and total types (2.40%); distribution of OPLL (2.40%); and K-line classification (4.19%). Six methods were based on computed tomography scans: free-type, contiguous-type, and broken sign (0.60%); hill-, plateau-, square-, mushroom-, irregular-, or round-shaped (5.99%); rectangular, oval, triangular, or pedunculate (1.20%); centralized or laterally deviated (1.80%); plank-, spindle-, or rod-shaped (0.60%); and rule of nine (0.60%). Classification systems based on 3-dimensional computed tomography were bridging and nonbridging (1.20%) and flat, irregular, and localized (0.60%). A single classification system was based on magnetic resonance imaging: triangular, teardrop, or boomerang. Finally, a variation of methods was used to classify OPLL associated with the dura mater (4.19%).

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“…Cervical flexion may induce more significant spinal cord compression in patients with kyphosis and K-line (-) patients. [13][14][15] The K-line concept appears to be a simple and practical method for determining the optimal surgical approach.…”

Section: Classification Based On Sagittal Relationship Between Opll Amentioning

confidence: 99%

Review of Radiological Parameters, Imaging Characteristics, and Their Effect on Optimal Treatment Approaches and Surgical Outcomes for Cervical Ossification of the Posterior Longitudinal Ligament

Shimokawa¹,

Sato²,

Matsumoto³

et al. 2019

Neurospine

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Determining the optimal surgical method for cervical ossification of the posterior longitudinal ligament (OPLL) is challenging. The surgical indication should be made based on not only radiological findings, but also the patient's age, preoperative neurological findings, social background, activities of daily life, and the presence or absence of comorbid diseases. Anterior resection for OPLL with or without wide corpectomy and fusion, posterior decompression with or without relatively long fusion, or anterior and posterior combined surgery may be considered. When evaluating the clinical condition of patients with cervical OPLL before surgery, various radiological parameters should be carefully considered, including the number of spinal segments involved, the cervical alignment or tilt angle, the relationship between OPLL and the C2-7 line (termed the "K-line"), the occupying ratio of OPLL, and the involvement of dural ossification. The objective of this article is to review the radiological parameters in current use for deciding upon the optimal surgical strategy and for predicting surgical outcomes, focusing on cervical OPLL.

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Influence of Spinous Process Spacers on Surgical Outcome of Laminoplasty for OPLL

Cited by 8 publications

References 23 publications

Prognostic factors for surgical outcome in spinal cord injury associated with ossification of the posterior longitudinal ligament (OPLL)

Prognostic factors for surgical outcome in spinal cord injury associated with ossification of the posterior longitudinal ligament (OPLL)

A Systematic Review of Classification Systems for Cervical Ossification of the Posterior Longitudinal Ligament

Review of Radiological Parameters, Imaging Characteristics, and Their Effect on Optimal Treatment Approaches and Surgical Outcomes for Cervical Ossification of the Posterior Longitudinal Ligament

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