Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Shandong, China.
Spine (Phila Pa 1976). 2019 Feb 1;44(3):E150-E156. doi: 10.1097/BRS.0000000000002807.
Retrospective study.
To analyze the radiological characteristics and surgical outcome of cervical ossification of posterior longitudinal ligament (OPLL) involving C2 level.
The study and report focused on the OPLL involving C2 level are rare. Therefore, the radiological characteristics and surgical outcome remain unclear.
The records of the patients with OPLL involving C2 level who underwent posterior surgery from July 2006 through October 2015 were retrospectively reviewed. The types, longitudinal and transverse extent, occupation ratio, K-line classification of OPLL, and high-intensity zone of spine cord on magnetic resonance imaging were analyzed to evaluate the radiological characteristics. All the cases received posterior open-door laminoplasty and instrumented fusion surgery. The Japanese Orthopedic Association (JOA) score and recovery rate (RR) were used to evaluate neurological function after surgery.
A total of 45 patients with OPLL involving C2 level were enrolled in the study. Their radiological data were carefully analyzed. The mixed (73.3%) and continuous type (24.5%) were observed. The mean number of involved segments was 5.1. The narrowest spinal canal mostly located in the level of C3-C4 and mean occupying ratio was 65.3%. Thirty-two patients were followed up for at least 2 years and the mean follow-up time was 46.2 months. The mean JOA score was 10.3 preoperatively and 15.2 at the final follow-up and the mean RR was 70.7%. The K-line (+) and (-) subgroups showed similar preoperative JOA score and RR. The high-intensity zone (+) subgroup showed lower preoperative JOA score but equal RR with (-) subgroup.
When OPLL involve C2 level, it often presented different radiological characteristics. The posterior open-door laminoplasty and instrumented fusion surgery could achieve favorable clinical outcomes. Further researches and long-term clinical follow-up are needed to better appreciate the OPLL involving C2 level.
回顾性研究。
分析累及 C2 水平的颈椎后纵韧带骨化症（OPLL）的影像学特征和手术结果。
目前，专门针对累及 C2 水平的 OPLL 的研究和报告较为少见，因此，其影像学特征和手术结果仍不清楚。
回顾性分析 2006 年 7 月至 2015 年 10 月期间接受后路手术治疗的累及 C2 水平的 OPLL 患者的病历资料。分析 OPLL 的类型、纵向和横向范围、占比、K 线分类、磁共振成像上脊髓高信号区，以评估影像学特征。所有病例均接受后路开门椎管扩大成形术和器械融合术。采用日本骨科协会（JOA）评分和恢复率（RR）评估术后神经功能。
本研究共纳入 45 例累及 C2 水平的 OPLL 患者。对其影像学资料进行了仔细分析。观察到混合型（73.3%）和连续型（24.5%）。受累节段数平均为 5.1 个。椎管最狭窄处多位于 C3-C4 水平，平均占比为 65.3%。32 例患者获得至少 2 年随访，平均随访时间为 46.2 个月。术前 JOA 评分为 10.3 分，末次随访时为 15.2 分，RR 平均为 70.7%。K 线（+）和（-）亚组术前 JOA 评分和 RR 相似。高信号区（+）亚组术前 JOA 评分较低，但与（-）亚组 RR 相当。
当 OPLL 累及 C2 水平时，其影像学特征常存在差异。后路开门椎管扩大成形术和器械融合术可获得良好的临床效果。需要进一步的研究和长期的临床随访，以更好地了解累及 C2 水平的 OPLL。
4 级。
