Effect of posterior decompression with and without fixation on a kyphotic cervical spine with ossification of the posterior longitudinal ligament.
Humans
Longitudinal Ligaments
/ diagnostic imaging
Osteogenesis
Decompression, Surgical
/ methods
Spinal Cord Injuries
/ surgery
Ossification of Posterior Longitudinal Ligament
/ complications
Cervical Vertebrae
/ diagnostic imaging
Kyphosis
/ diagnostic imaging
Treatment Outcome
Spinal Fusion
/ methods
Journal
Spinal cord
ISSN: 1476-5624
Titre abrégé: Spinal Cord
Pays: England
ID NLM: 9609749
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
received:
27
04
2022
accepted:
21
09
2022
revised:
20
09
2022
pubmed:
11
10
2022
medline:
3
3
2023
entrez:
10
10
2022
Statut:
ppublish
Résumé
Biomechanical study. Cervical ossification of the posterior longitudinal ligament (C-OPLL) causes myelopathy. Though posterior decompression for C-OPLL showed positive results, poor outcomes were seen in patients with a kyphotic alignment. Posterior decompression with fusion (PDF) tends to show better results compared to posterior decompression. The aim of this study is to evaluate the effects of the posterior procedures for C-OPLL. Yamaguchi University. Based on 3D finite element C2-C7 spine created from medical images and a spinal cord, the following compression models were created: the intact model, K-line 0 mm model, and K-line 2 mm model. These models were used to analyze the effects of posterior decompression with varied lengths of fixation. The stress of the spinal cord was calculated for intact, K-line 0 mm, and K-line 2 mm as preoperative models, and laminectomy (LN)-K-line 0 mm, PDF (C4-C5)-K-line 0 mm, PDF (C3-C6)-K-line 0 mm, LN-K-line 2 mm, PDF (C4-C5)-K-line 2 mm, and PDF (C3-C6)-K-line 2 mm model as operative models in a neutral, flexion, and extension. As the compression increased, stress on the spinal cord increased compared to the intact model. In the neutral, posterior decompression decreased the stress of the spinal cord. However, in flexion and extension, the stress on the spinal cord for LN-K-line 0 or 2 mm, PDF (C4-C5)-K-line 0 or 2 mm, and PDF (C3-C6)-K-line 0 or 2 mm models decreased by more than 40%, 43%, and 70% respectively compared to the K-line 0 or 2 mm model. In kyphotic C-OPLL, it is essential to control intervertebral mobility in the posterior approach.
Identifiants
pubmed: 36216915
doi: 10.1038/s41393-022-00857-z
pii: 10.1038/s41393-022-00857-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
133-138Informations de copyright
© 2022. The Author(s), under exclusive licence to International Spinal Cord Society.
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