PMID- 23815254
OWN - NLM
STAT- MEDLINE
DCOM- 20140312
LR  - 20220409
IS  - 1092-0684 (Electronic)
IS  - 1092-0684 (Linking)
VI  - 35
IP  - 1
DP  - 2013 Jul
TI  - Is there a difference in range of motion, neck pain, and outcomes in patients 
      with ossification of posterior longitudinal ligament versus those with cervical 
      spondylosis, treated with plated laminoplasty?
PG  - E9
LID - 10.3171/2013.4.FOCUS1394 [doi]
AB  - OBJECT: There are little data on the effects of plated, or plate-only, open-door 
      laminoplasty on cervical range of motion (ROM), neck pain, and clinical outcomes. 
      The purpose of this study was to compare ROM after a plated laminoplasty in 
      patients with ossification of posterior longitudinal ligament (OPLL) versus those 
      with cervical spondylotic myelopathy (CSM) and to correlate ROM with 
      postoperative neck pain and neurological outcomes. METHODS: The authors 
      retrospectively compared patients with a diagnosis of cervical stenosis due to 
      either OPLL or CSM who had been treated with plated laminoplasty in the period 
      from 2007 to 2012 at the University of California, San Francisco. Clinical 
      outcomes were measured using the modified Japanese Orthopaedic Association (mJOA) 
      scale and neck visual analog scale (VAS). Radiographic outcomes included 
      assessment of changes in the C2-7 Cobb angle at flexion and extension, ROM at 
      C2-7, and ROM of proximal and distal segments adjacent to the plated lamina. 
      RESULTS: Sixty patients (40 men and 20 women) with an average age of 63.1 +/- 10.9 
      years were included in the study. Forty-one patients had degenerative CSM and 19 
      patients had OPLL. The mean follow-up period was 20.9 +/- 13.1 months. The mean 
      mJOA score significantly improved in both the CSM and the OPLL groups (12.8 to 
      14.5, p < 0.01; and 13.2 to 14.2, respectively; p = 0.04). In the CSM group, the 
      mean VAS neck score significantly improved from 4.2 to 2.6 after surgery (p = 
      0.01), but this improvement did not reach the minimum clinically important 
      difference (MCID). Neither was there significant improvement in the VAS neck 
      score in the OPLL group (3.6 to 3.1, p = 0.17). In the CSM group, ROM at C2-7 
      significantly decreased from 32.7 degrees  before surgery to 24.4 degrees  after surgery (p < 
      0.01). In the OPLL group, ROM at C2-7 significantly decreased from 34.4 degrees  to 20.8 degrees  
      (p < 0.01). In the CSM group, the change in the VAS neck score significantly 
      correlated with the change in the flexion angle (r = - 0.31) and the extension 
      angle (r = - 0.37); however, it did not correlate with the change in ROM at C2-7 
      (r = - 0.1). In the OPLL group, the change in the VAS neck score did not 
      correlate with the change in the flexion angle (r = 0.03), the extension angle (r 
      = - 0.17), or the ROM at C2-7 (r = - 0.28). The OPLL group had a significantly 
      greater loss of ROM after surgery than did the CSM group (p = 0.04). There was no 
      significant correlation between the change in ROM and the mJOA score in either 
      group. CONCLUSIONS: Plated laminoplasty in patients with either OPLL or CSM 
      decreases cervical ROM, especially in the extension angle. Among patients who 
      have undergone laminoplasty, those with OPLL lose more ROM than do those with 
      CSM. No correlation was observed between neck pain and ROM in either group. 
      Neither group had a change in neck pain that reached the MCID following 
      laminoplasty. Both groups improved in neurological function and outcomes.
FAU - Fujimori, Takahito
AU  - Fujimori T
AD  - Department of Neurosurgery, University of California, San Francisco, California, 
      USA.
FAU - Le, Hai
AU  - Le H
FAU - Ziewacz, John E
AU  - Ziewacz JE
FAU - Chou, Dean
AU  - Chou D
FAU - Mummaneni, Praveen V
AU  - Mummaneni PV
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Neurosurg Focus
JT  - Neurosurgical focus
JID - 100896471
SB  - IM
MH  - Aged
MH  - Cervical Vertebrae/diagnostic imaging/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Laminectomy/*methods
MH  - Male
MH  - Middle Aged
MH  - Neck Pain/diagnostic imaging/physiopathology/*surgery
MH  - Ossification of Posterior Longitudinal Ligament/diagnostic 
      imaging/physiopathology/*surgery
MH  - Radiography
MH  - Range of Motion, Articular/*physiology
MH  - Retrospective Studies
MH  - Spondylosis/diagnostic imaging/physiopathology/*surgery
MH  - Treatment Outcome
EDAT- 2013/07/03 06:00
MHDA- 2014/03/13 06:00
CRDT- 2013/07/03 06:00
PHST- 2013/07/03 06:00 [entrez]
PHST- 2013/07/03 06:00 [pubmed]
PHST- 2014/03/13 06:00 [medline]
AID - 10.3171/2013.4.FOCUS1394 [doi]
PST - ppublish
SO  - Neurosurg Focus. 2013 Jul;35(1):E9. doi: 10.3171/2013.4.FOCUS1394.