The efficacy of laminoplasty and laminectomy with fusion for ossification of the posterior longitudinal ligament with high occupation rate in the cervical spine is not clear in the literature report so far. This study is designed to further research the difference in efficacy between the two surgical methods.
Ossification of the posterior longitudinal ligament(OPLL) is a common spinal disease which can lead to neurological dysfunction and its morbidity is related to genetic factors. OPLL is usually found in cervical spine and characterized by hypertrophy and ossification of the posterior longitudinal ligament in the rear of the corresponding cervical vertebral body, which can encroach the space in the spinal canal and compress the spinal cord and/or nerve roots of the corresponding segments, resulting in sensory and motor disorders of the limbs as well as visceral autonomic nervous dysfunction, leading to neurological dysfunction and even high paraplegia. It not only causes great harm but also brings heavy economic and spiritual burden to patients and society. Although the surgical treatments for OPLL include anterior and posterior approach, the anterior approach requires excellent equipment and rich operation experience for surgery doctor. Many articles showed significantly higher complications rate in anterior approach than that of posterior approach. Posterior approach surgery is considered to be one of the effective treatment methods for OPLL in cervical spine. In the posterior approach, there are two commonly recognized surgical procedures, laminoplasty and laminectomy with fusion. The efficacy of laminoplasty and laminectomy with fusion for ossification of the posterior longitudinal ligament with high occupation rate in the cervical spine is not clear in the literature report so far. This study is designed to further research the difference in efficacy between the two surgical methods. The purpose of this study is to make patients get the biggest medical benefits and to make a right surgical treatment strategy when doctors treating patients with high occupation rate OPLL in cervical spine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
A posterior approach surgical method to treat patients with Ossification of the Posterior Longitudinal Ligament
Another posterior approach surgical method to treat patients with Ossification of the Posterior Longitudinal Ligament
Peking University Third Hospital
Beijing, Beijing Municipality, China
preoperative mJOA score
Preoperative mJOA score, range from 0 to 17. The higher the score, the less severe the symptoms
Time frame: preoperative
postoperative mJOA score
Postoperative mJOA score, range from 0 to 17. The higher the score, the less severe the symptoms
Time frame: postoperative at 3 months
postoperative mJOA score
Postoperative mJOA score, range from 0 to 17. The higher the score, the less severe the symptoms
Time frame: postoperative at 6 months
postoperative mJOA score
Postoperative mJOA score, range from 0 to 17. The higher the score, the less severe the symptoms
Time frame: postoperative at 1 year
postoperative mJOA score
Postoperative mJOA score, range from 0 to 17. The higher the score, the less severe the symptoms
Time frame: postoperative at 2 year
mJOA score change rate
(Postoperative mJOA score-Preoperative mJOA score)/(17-Preoperative mJOA score)×100%
Time frame: 3 months after surgery
mJOA score change rate
(Postoperative mJOA score-Preoperative mJOA score)/(17-Preoperative mJOA score)×100%
Time frame: 6 months after surgery
mJOA score change rate
(Postoperative mJOA score-Preoperative mJOA score)/(17-Preoperative mJOA score)×100%
Time frame: 1 year after surgery
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NONE
Enrollment
100
mJOA score change rate
(Postoperative mJOA score-Preoperative mJOA score)/(17-Preoperative mJOA score)×100%
Time frame: 2 years after surgery
Operation time
Operation time during operation
Time frame: during operation
blood loss
blood loss during operation, parameter is milliliter, which is caculated by anesthetist during operation
Time frame: during operation
Rate of C5 nerve root palsy
Whether patient has deltoid muscle strength decrease after operation. If there is, it means to appear C5 palsy.
Time frame: C5 nerve palsy after operation immediately
hematoma incidence
hematoma after operation
Time frame: hematoma after operation immediately
Rate of spinal cord injury
Whether patient has spinal cord injury after operation. If there is, it means to appear sensory and motor impairments of limbs and trunk.
Time frame: spinal cord injury after operation immediately
range of motion
the movement range of cervical
Time frame: preoperation
range of motion
the movement range of cervical
Time frame: 3 months after surgery
range of motion
the movement range of cervical
Time frame: 6 months after surgery
range of motion
the movement range of cervical
Time frame: 1 year after surgery
range of motion
the movement range of cervical
Time frame: 2 years after surgery
neck pain VAS score
Visual Analog Score for pain of neck, range from 0-10, a higher score means more pain
Time frame: 3 months after surgery
neck pain VAS score
Visual Analog Score for pain of neck, range from 0-10, a higher score means more pain
Time frame: 6 months after surgery
neck pain VAS score
Visual Analog Score for pain of neck, range from 0-10, a higher score means more pain
Time frame: 1 year after surgery
neck pain VAS score
Visual Analog Score for pain of neck, range from 0-10, a higher score means more pain
Time frame: 2 years after surgery