Ogawa Yuto
Department of Orthopaedic Surgery, Saitama Social Insurance Hospital.
Clin Calcium. 2009 Oct;19(10):1493-8.
Clinical results of expansive laminoplasty (ELAP) for ossification of the posterior longitudinal ligament (OPLL) of the cervical spine are satisfactory and are preserved for long period. ELAP is also thought to be easier and safer procedure than anterior fusion for OPLL of the cervical spine. However, appropriate decompression can not be achieved by ELAP without sufficient dorsal shift of the spinal cord, because pathological lesion exists ventral to the spinal cord in patients with OPLL. Kyphotic alignment, high OPLL occupying ratio, hill-shaped ossification are considered to be risk factors contributing to inappropriate decompression. To acquire satisfactory operative results, careful consideration for the indication of ELAP should be necessary for each patient.
颈椎后纵韧带骨化症（OPLL）行扩大椎板成形术（ELAP）的临床效果令人满意且可长期维持。ELAP也被认为是一种比颈椎OPLL前路融合术更简单、更安全的手术。然而，对于颈椎OPLL患者，由于脊髓腹侧存在病理性病变，若脊髓没有足够的背侧移位，ELAP就无法实现充分减压。后凸畸形、高OPLL占位率、山形骨化被认为是导致减压不充分的危险因素。为获得满意的手术效果，应对每位患者仔细考虑ELAP的适应证。
