One-stage posterior laminectomy with instrumented fusion and foraminotomy for cervical ossification of posterior longitudinal ligament with radiculopathy pain

Journal of Orthopaedic Surgery and Research, 2021 · DOI: https://doi.org/10.1186/s13018-021-02431-4 · Published: May 8, 2021

Surgery Orthopedics Spinal Disorders

Simple Explanation

This study investigates the effectiveness of a surgical technique, LFF, compared to LF, for treating cervical OPLL patients experiencing radicular arm pain. LFF involves laminectomy with instrumented fusion and foraminotomy, while LF involves laminectomy with instrumented fusion alone. The study assesses clinical and imaging outcomes to determine which approach is more beneficial. The research aims to provide insights into optimizing surgical interventions for OPLL patients with radiculopathy, potentially improving their neurological function and reducing arm pain.

Study Duration

24–42 months

Participants

48 OPLL patients with radicular pain

Evidence Level

Not specified

Key Findings

1
The VAS score for arm pain was significantly lower in the LFF group compared with the LF group, indicating better pain relief.
2
The surgical duration was longer in the LFF group compared to the LF group, reflecting the additional time required for foraminotomy.
3
Postoperative C5 palsy and axial symptom did not occur in the LFF group but was observed in 2 of the 24 patients (8.3%) in the LF group.

Research Summary

This study retrospectively compared one-stage posterior LFF and LF for cervical OPLL patients with radicular pain, finding LFF more effective in relieving arm pain. While LFF resulted in longer operative times, it was associated with a lower incidence of postoperative C5 palsy and axial symptoms compared to LF. The study concludes that LFF can achieve satisfactory clinical outcomes in improving neurological function and relieving radicular pain in OPLL patients with radiculopathy.

Practical Implications

Surgical Technique Selection

LFF may be considered as a preferential surgical technique for OPLL patients with radicular pain due to its superior pain relief and lower incidence of certain complications compared to LF.

Reduced Post-operative Complications

Foraminotomy during posterior cervical surgery for OPLL may reduce the risk of C5 nerve palsy.

Operative Planning

Surgeons should consider the potential for increased operative time when performing LFF, and weigh the benefits against the additional time investment.

Study Limitations

1
The retrospective nature of this study did not allow us to prospectively test our hypothesis.
2
The case series was limited based on a single center’s experience.
3
The follow-up period was relatively short (mean 31.1 months).

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