Chen Chong, Ye Wenlin, Yu Tao, Cheng Xing, Wang Lutong, Zhao Xingchen, Long Xiang, Ouyang Jun, Chang Yunbing, Zheng Xiaoqing
Department of Spine Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106, Zhongshan 2nd Rd, Guangzhou, Guangdong, 510080, China.
Guangdong Provincial Key Laboratory of Medical Biomechanics & Guangdong Engineering Research Center for Translation of Medical 3D Printing Application & National Virtual & Reality Experimental Education Center for Medical Morphology & National Experimental Education Demonstration Center for Basic Medical Sciences, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China.
BMC Musculoskelet Disord. 2025 May 24;26(1):511. doi: 10.1186/s12891-025-08729-2.
A retrospective study.
This study aims to investigate the relationship between the resection of ossification of the nuchal ligament (ONL), its morphological features, and cervical stability following modified laminoplasty.
We retrospectively reviewed the data of patients diagnosed as degenerative cervical myelopathy (DCM) who underwent modified laminoplasty with muscle-ligament complex (MLC) reconstruction in our hospital between July 2018 and October 2022. Demographic information (e.g., age, gender), cervical sagittal parameters, cervical angular displacement (AD), cervical horizontal displacement (HD), range of motion and patient-reported outcomes were compared between patients with and without ONL.
The cervical AD at C4-C5, C5-C6 and cervical HD at C5-6 were significantly higher in ONL (+) group than ONL (-) group before surgery and at the 24-month follow-up time (p < 0.05, all). The AD and HD at C4-C5 and C5-C6 were higher in ONL (+) segments before surgery and at the 24-month follow-up (p < 0.05, all). But the values of AD or HD were lower in ONL (+) segments at 3- or 6-month follow-up (p < 0.05, all). ONL (+) group with two or more consecutive segments demonstrate significantly increased cervical AD and HD at the C4-C5 level after a 24-month follow-up period (p < 0.01, both).
Resection of the ONL, particularly involving ≥ 2 cervical segments, is moderately associated with an increased likelihood of cervical instability and abnormal sagittal alignment in long-term follow-up after laminoplasty. Reconstruction of the MLC during laminoplasty may enhance cervical stability in the early follow-up period. For DCM patients with long segmental ONL, more attention should be paid to protecting the MLC structure during posterior cervical surgery.
Not applicable.
一项回顾性研究。
本研究旨在探讨项韧带骨化（ONL）切除术、其形态学特征与改良椎板成形术后颈椎稳定性之间的关系。
我们回顾性分析了2018年7月至2022年10月期间在我院接受肌肉-韧带复合体（MLC）重建改良椎板成形术的诊断为退行性颈椎脊髓病（DCM）患者的数据。比较了有和没有ONL的患者的人口统计学信息（如年龄、性别）、颈椎矢状位参数、颈椎角位移（AD）、颈椎水平位移（HD）、活动范围和患者报告的结果。
术前和24个月随访时，ONL（+）组C4-C5、C5-C6节段的颈椎AD以及C5-6节段的颈椎HD均显著高于ONL（-）组（均p<0.05）。术前和24个月随访时，ONL（+）节段C4-C5和C5-C6的AD和HD更高（均p<0.05）。但在3个月或6个月随访时，ONL（+）节段的AD或HD值较低（均p<0.05）。连续两个或更多节段的ONL（+）组在24个月随访期后C4-C5水平的颈椎AD和HD显著增加（均p<0.01）。
在椎板成形术后的长期随访中，ONL切除术，特别是涉及≥2个颈椎节段，与颈椎不稳定和矢状位排列异常的可能性增加中度相关。椎板成形术期间MLC的重建可能会在早期随访期增强颈椎稳定性。对于长节段ONL的DCM患者，颈椎后路手术期间应更加注意保护MLC结构。
不适用。
