Posterior decompression and fusion versus laminoplasty for cervical ossification of posterior longitudinal ligament: a s
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ORIGINAL ARTICLE
Posterior decompression and fusion versus laminoplasty for cervical ossification of posterior longitudinal ligament: a systematic review and meta-analysis Ping Xu 1 & Guo-Dong Sun 1 & Lu Xun 2 & Shi-Shu Huang 1 & Zhi-Zhong Li 1,3 Received: 10 March 2020 / Revised: 25 April 2020 / Accepted: 11 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Both posterior decompression and fusion (PDF) and laminoplasty (LAMP) have been used to treat cervical myelopathy due to multilevel ossification of posterior longitudinal ligament (OPLL). However, considerable controversy exists over the choice of the two surgical strategies. Thus, the aim of this study is to compare clinical outcomes of PDF and LAMP for treatment of cervical myelopathy due to multilevel OPLL. We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials database to identify relevant clinical studies compared with clinical outcomes of PDF and LAMP for cervical OPLL. The primary outcomes including Japanese Orthopaedic Association (JOA) score and recovery rate of JOA were evaluated, and the secondary outcomes involving visual analogue scale (VAS), cervical curvature, OPLL progression rate, complication rate, reoperation rate and surgical trauma were also evaluated using Stata software. A total of nine studies were included in the current study, involving 324 patients. The current study suggests that compared with LAMP, PDF achieves a lower OPLL progression rate, better postoperative cervical curvature and similar neurological improvement in the treatment of multilevel cervical OPLL. However, PDF has a higher complication rate, more surgical trauma and higher postoperative VAS than LAMP. Keywords Posterior decompression and fusion . Laminoplasty . OPLL . Cervical myelopathy . Complication
Introduction Ossification of posterior longitudinal ligament (OPLL) refers to an ectopic bone formation in spinal ligament. It often causes the compression of spinal cord due to the spinal stenosis [30]. Patients with various myelopathic symptoms due to OPLL
usually require surgical intervention rather than conservative treatments. Despite a direct decompression of spinal cord has been achieved by the removal of the ossified lesion in the cervical anterior operation, it is associated with high technical criteria and life-threatening complications such as esophageal perforation and airway obstruction [8, 18, 34]. In order to
Investigation performed at the Department of Spinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People’s Republic of China. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10143-020-01317-z) contains supplementary material, which is available to authorized users. * Shi-Shu Huang [email protected]
Lu Xun [email protected]
* Zhi-Zhong Li [email protected]
1
Ping Xu [email protected]
Department of Spinal Surgery, The First Affiliated Hospital of Jinan University, 601 West Whampoa Avenue, Guangzhou 510000, Ch
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