Consecutive patients of cervical myelopathy caused by OPLL were analyzed retrospectively. The clinical outcomes were evaluated using Visual Analogue Scale scores of the neck and arm pain and the Japanese Orthopaedic Association scores. Radiologic measurements included flexion ROM (fROM), which was defined as the difference of cervical lordosis in flexion and neutral positions, extension ROM (eROM), defined as the difference between neutral and extension positions, and gROM, defined as the difference between fROM and eROM. Patients were grouped by the values of gROM, and comparisons of all outcomes were made between the groups.
A total of 42 patients underwent surgery. The patients with greater gROM did not differ from those with smaller gROM by demographic characteristics. During follow-up (mean 45.8 months), both groups had similar improvements, but the C5 palsy rates were higher in the greater gROM group than in the smaller gROM group (71% and 22%, P < 0.05).
Simultaneous circumferential decompression and fixation is an effective surgical option for patients with cervical myelopathy caused by OPLL. A higher rate of postoperative C5 palsy was observed in the patients with greater gROMs after surgery, although all patients presented with similar clinical improvements.
方法:对OPLL引起的连续脊髓型颈椎病患者进行回顾性分析。使用颈部和手臂疼痛的视觉模拟评分评估临床结果。和日本骨科协会的分数。放射学测量包括屈曲ROM(fROM),定义为颈椎前凸在屈曲位和中立位的差异,扩展ROM(eROM),定义为中立位置和伸展位置之间的差异,和gROM,定义为fROM和eROM之间的区别。患者按gROM值分组,并对所有结局进行组间比较.
结果:共有42例患者接受了手术。gROM较大的患者与gROM较小的患者在人口统计学特征上没有差异。随访期间(平均45.8个月),两组都有类似的改善,但大gROM组的C5麻痹率高于小gROM组(71%和22%,p<0.05)。
结论:对于OPLL引起的脊髓型颈椎病患者,同时进行圆周减压和固定是一种有效的手术选择。在手术后gROM较大的患者中,术后C5麻痹的发生率更高,尽管所有患者均表现出相似的临床改善。