Open Door Versus Double Door Laminoplasty in the Treatment of Cervical OPLL: A 10-Year Retrospective Analysis.
retrospective_cohort · Level III
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- Also identified by DOI 10.1227/neu.0000000000003970.
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Abstract
This study compared the surgical outcomes of open-door (OD) and double-door (DD) laminoplasties in patients with cervical ossification of the posterior longitudinal ligament (OPLL). This single-center study included 62 patients in the OD group and 47 patients in the DD group, all of whom were evaluated over a 10-year follow-up period. We assessed demographics, surgical levels, occupying ratio, K-line classification, type of OPLL, C2-C7 Cobb angle, cervical OPLL volume, and range of motion (ROM). Clinical outcomes were assessed using visual analog scale score, Japanese Orthopedic Association (JOA) score, and recovery rate. No significant differences were observed in age, sex, symptom duration, comorbidities, K-line type, and canal-occupying ratio. Six patients in each group underwent reoperation. The C2-7 Cobb angle remained similar preoperatively, immediately after surgery, or 2 years after surgery. At the 10-year follow-up, the extension angle and ROM were significantly lower in the DD group, although the overall ROM change from baseline was not significant different. OPLL volume was significantly greater in the OD group at 10 years. The visual analog scale scores for the neck and arm were significantly lower in the DD group than in the OD group immediately after surgery, with no difference between the groups at 10 years postsurgery. The JOA scores showed a similar improvement at 10 years postoperatively. Both laminoplasty methods were effective for long-term treatment of cervical OPLL, providing similar clinical outcomes and improvement in the JOA score over a 10-year follow-up period. However, the ROM decreased significantly more in the DD group than in the OD group, especially in patients younger than 50 years of age. These findings suggest that, although both techniques are viable options, patient age and preservation of cervical ROM may be important considerations in the choice of surgical method.