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Study Design: Alignment of the cervical spine (C2 to C7 angle) after open-door laminoplasty, with the posterior cervical ligamentous complex and the insertion of an extensor reattach, was investigated retrospectively in patients with ossification of the posterior longitudinal ligament (OPLL) with disease extent reaching the epistropheus.Objective: Methods of posterior decompression and extensor reconstruction in the treatment of OPLL with disease extent reaching the epistropheus have been investigated in this paper.Methods: In 10 cases of OPLL with disease extent reaching C2, in which posterior cervical ligamentous complexes are retained, the C2 attachment point of the extensor was reattached and open-door cervical laminoplasty was performed, with the decompression range of laminoplasty being C2-C7. The average follow-up period was 14 months.Observation: The C2 effective vertebral canal sagittal diameter before and after surgery was determined using computed tomography in order to observe the decompression degree; the C2-C7 angle before and after the surgery was measured using an x-ray, and maintenance of the physiological curve was then observed; JOA scoring was carried out before and after the operation and during follow-up.Results: The average effective vertebral canal sagittal diameter before the surgery was 5.6 mm (4 to 8.8 mm), whereas that after the surgery was 13.4 mm (10 to 18.2 mm) (P<0.01, compared with that before the operation); the C2-C7 angle of the neutral position was 6.5 degrees (-2 to 12 degrees), whereas that after surgery was 7.4 degrees (3 to 14 degrees) and that during the last follow-up was 7.0 degrees (2 to 15 degrees) (P>0.05, compared with that before the operation); the JOA score before the surgery was between 6 and 12 with an average of 9.6, whereas that after the surgery was between 8 and 14 with an average of 10.9 and that during the last follow-up was between 10 and 17 with an average of 13.2 (P<0.05, compared with that before the operation).Conclusions: The open-door cervical laminoplasty in which posterior cervical ligamentous complexes are retained and the attachment point of extensor muscles is reconstructed is applicable to OPLL with disease extent reaching the epistropheus, and the objective of complete decompression and the maintenance of physiological curve of cervical vertebra can be achieved.
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NEUROSURGERY QUARTERLY
ISSN: 1050-6438
年份: 2013
期: 3
卷: 23
页码: 184-188