Tanaka Hirotomo, Takaishi Yoshiyuki, Kajimoto Hiroto, Sugihara Masahiro, Kondoh Takeshi, Sasayama Takashi
Neurosurgery, Shinsuma General Hospital, Kobe, JPN.
Neurosurgery, Kobe University Graduate School of Medicine, Kobe, JPN.
Cureus. 2025 Mar 19;17(3):e80861. doi: 10.7759/cureus.80861. eCollection 2025 Mar.
Cervical laminoplasty using hydroxyapatite spacers is a surgical procedure widely performed for managing spondylotic myelopathy and ossification of the posterior longitudinal ligament (OPLL). Despite the procedure's efficacy, the mechanisms underlying bone formation in OPLL remain poorly understood, and postoperative ectopic ossification may still occur. After laminoplasty, we compared bone bridge formation between adjacent hydroxyapatite spacers in patients with cervical spondylotic myelopathy and OPLL.
A retrospective analysis was conducted on 30 patients who underwent double-door laminoplasty involving two or more consecutive laminae between 2006 and 2020. The median patient age was 62 years (42-87 years), with 21 male and nine female patients. Bone bridge formation over an extended postoperative period was evaluated and compared between spondylotic myelopathy (n=16) and OPLL groups (n=14).
The median duration from laminoplasty to the last postoperative CT scan was 65 months in the spondylotic myelopathy group and 84 months in the OPLL group. No significant intergroup difference was observed between groups (p=0.45). New bone bridges were identified in five of the 16 patients with spondylotic myelopathy (31%) and nine of the 14 patients with OPLL (64%). The difference was not statistically significant (p=0.079). Throughout the observation period, all but one patient demonstrated stable neurological function.
The incidence of bone bridge formation between adjacent hydroxyapatite spacers did not significantly differ between patients with and without spondylotic myelopathy. Hydroxyapatite spacers in laminoplasty were safe and effective under both conditions.
使用羟基磷灰石间隔物进行颈椎椎板成形术是一种广泛用于治疗脊髓型颈椎病和后纵韧带骨化症（OPLL）的外科手术。尽管该手术具有疗效，但OPLL中骨形成的潜在机制仍知之甚少，术后仍可能发生异位骨化。在椎板成形术后，我们比较了脊髓型颈椎病和OPLL患者相邻羟基磷灰石间隔物之间的骨桥形成情况。
对2006年至2020年间接受涉及两个或更多连续椎板的双开门椎板成形术的30例患者进行回顾性分析。患者的中位年龄为62岁（42 - 87岁），其中男性21例，女性9例。评估并比较了脊髓型颈椎病组（n = 16）和OPLL组（n = 14）在延长的术后期间的骨桥形成情况。
脊髓型颈椎病组从椎板成形术到最后一次术后CT扫描的中位时间为65个月，OPLL组为84个月。两组之间未观察到显著的组间差异（p = 0.45）。16例脊髓型颈椎病患者中有5例（31%）发现了新的骨桥，14例OPLL患者中有9例（64%）发现了新的骨桥。差异无统计学意义（p = 0.079）。在整个观察期内，除1例患者外，所有患者的神经功能均保持稳定。
有无脊髓型颈椎病的患者之间，相邻羟基磷灰石间隔物之间骨桥形成的发生率无显著差异。在这两种情况下，椎板成形术中使用羟基磷灰石间隔物都是安全有效的。
