Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, China.
Neurosurg Rev. 2024 Aug 29;47(1):505. doi: 10.1007/s10143-024-02735-z.
Ossification of the posterior longitudinal ligament (OPLL) is a common cause of degenerative cervical myelopathy (DCM) in Asian populations. Characterization of OPLL progression following laminoplasty remains limited in the literature. 29 patients with OPLL received cervical laminoplasty and a minimum of 2-years follow-up. Clinical and radiological surveillance occurred at 3-months, 6-months, 12-months post-op and then at yearly intervals. Transverse (anteroposterior) diameter and sagittal length of OPLL in relation to their cervical vertebral level of localisation was assessed upon immediate post-op radiographs compared to those obtained at subsequent follow-up. OPLL progression was defined as an increase in transverse dimensions and/or length by ≥ 2 mm. The average period of clinical follow-up was 6.7 ± 3.3 years. Upon latest follow-up, 79% of patients demonstrated at least 2 mm of transverse or longitudinal progression of OPLL. This corresponded to 2-years and 5-year progression rates of 54% and 71% respectively. OPLL located over C5 demonstrated the greatest transverse progression rate at (0.24 ± 0.34 mm / year). The mean overall longitudinal progression rate was 1.61 ± 2.06 mm / year. No patients experienced neurological decline resulting from OPLL progression requiring revision decompression during the period of post-operative observation. Characterizing transverse and longitudinal progression by cervical level via radiographs has implications in surgical planning for OPLL and should be consolidated upon post-operative CT/MRI scans as well as larger sample sizes.
后纵韧带骨化（OPLL）是亚洲人群退行性颈椎脊髓病（DCM）的常见病因。颈椎板成形术后 OPLL 进展的特征在文献中仍然有限。29 例 OPLL 患者接受颈椎板成形术和至少 2 年的随访。临床和影像学监测分别在术后 3 个月、6 个月、12 个月进行，然后每年进行一次。在即刻术后 X 光片上评估 OPLL 与其颈椎定位的颈椎椎体水平的横向（前后）直径和矢状长度，并与随后的随访结果进行比较。OPLL 进展定义为横向尺寸和/或长度增加≥2mm。平均临床随访时间为 6.7±3.3 年。在最新的随访中，79%的患者至少有 2mm 的 OPLL 横向或纵向进展。这相当于 2 年和 5 年的进展率分别为 54%和 71%。C5 以上的 OPLL 表现出最大的横向进展率（0.24±0.34mm/年）。总的纵向进展率平均为 1.61±2.06mm/年。在术后观察期间，没有患者因 OPLL 进展导致需要进行翻修减压的神经功能下降。通过 X 光片按颈椎水平对横向和纵向进展进行特征描述对 OPLL 的手术计划有影响，应在术后 CT/MRI 扫描以及更大的样本量上进行巩固。
