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Sun XF, Wang Y, Sun JC, Xu XM, Kong QJ, Chen Y, Yang HS, Liu Y, Guo YF, Shi GD, Chen XS, Chen DY, Shen Y, Hao DJ, Shen HX, Zhu QS, Yuan W, Jia LS, Shi JG. Consensus statement on diagnosis and treatment of cervical ossification of posterior longitudinal ligament from Asia Pacific Spine Society (APSS) 2020. J Orthop Surg (Hong Kong) 2021; 28:2309499020975213. [PMID: 33355038 DOI: 10.1177/2309499020975213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The study aimed to develop an evidence-based expert consensus statement on diagnosis and treatment of cervical ossification posterior longitudinal ligament (OPLL). METHOD Delphi method was used to perform such survey, and the panel members from Asia Pacific Spine Society (APSS) 2020 were invited to answer the open-ended questions in rounds 1 and 2. Then the results were summarized and developed into a Likert-style questionnaire for voting in round 3, and the level of agreement was defined as 80%. In the whole process, we conducted a systematic literature search on evidence for each statement. RESULTS Cervical OPLL can cause various degrees of neurological symptoms, an it's thought to be more common in Asia population. CT reconstruction is an important imaging examination to assist diagnosis and guide surgical choice. Segmental, continuous, mixed, and focal type is the most widely used classification system. The non-surgical treatment is recommended for patients with no or mild clinical symptoms, or irreversible neurological damage, or failed surgical decompression, or condition cannot tolerant surgery, or refusing surgery. As OPLL may continue to develop gradually, surgical treatment would be considered in their course inevitably. The surgical choice should depend on various conditions, such as involved levels, thickness, and type of OPLL, skill-experiences of surgeons, which are listed and discussed in the article. CONCLUSION In this statement, we describe the clinical features, classifications, and diagnostic criteria of cervical OPLL, and review various surgical methods (such as their indications, complications), and provide a guideline on their choice strategy.
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Affiliation(s)
- Xiao-Fei Sun
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yuan Wang
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Jing-Chuan Sun
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Xi-Ming Xu
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Qing-Jie Kong
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yu Chen
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Hai-Song Yang
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yang Liu
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yong-Fei Guo
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Guo-Dong Shi
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Xiong-Sheng Chen
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - De-Yu Chen
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Yong Shen
- Department of Spine Surgery, Hebei Medical University, The Third Hospital, Shijiazhuang, China
| | - Ding-Jun Hao
- Department of Spine Surgery, Xi'an Jiaotong University and Xi'an Medical College, Xi'an Honghui Hospital, Xi 'an, China
| | - Hong-Xing Shen
- Department of Spine Surgery, Shanghai Jiaotong University, Renji Hospital, Shanghai, China
| | - Qing-San Zhu
- Department of Spine Surgery, Jilin University, The First Bethune Hospital, Changchun, China
| | - Wen Yuan
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Lian-Shun Jia
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | - Jian-Gang Shi
- Department of Spine Surgery, Second Military Medical University, Changzheng Hospital, Shanghai, China
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Sun N, Liang Y, Hu B, Feng J, Lin G, Chen X, Rui G. circSKIL promotes the ossification of cervical posterior longitudinal ligament by activating the JNK/STAT3 pathway. Exp Ther Med 2021; 22:761. [PMID: 34035858 PMCID: PMC8135123 DOI: 10.3892/etm.2021.10193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/29/2021] [Indexed: 12/30/2022] Open
Abstract
Ossification of the posterior longitudinal ligament (OPLL) is a hyperostotic spinal condition that involves genetic factors as well as non-genetic factors, and its underlying molecular mechanism is largely unknown. Recently, circular RNAs (circRNAs) have been attracting the attention of researchers since they have important regulatory roles in many diseases, including bone metabolism disorders. The present study aimed to investigate the role of circRNA SKI-like proto-oncogene (circSKIL) in OPLL disease progression. First, primary posterior longitudinal ligament cells from patients with cervical spondylotic myelopathy (CSM) without OPLL (control group) and CSM patients with OPLL (OPLL group) were isolated, and the expression levels of circSKIL in ligament cells was found to be significantly increased in the OPLL group compared with control. This result was also confirmed in OPLL tissues. Next, circSKIL was overexpressed in control ligament cells, and the proliferation, mineralization, and osteogenic differentiation of ligament cells were found to be significantly enhanced; the phosphorylation levels of both JNK and STAT3 were upregulated. By contrast, the knockdown of circSKIL in OPLL ligament cells inhibited proliferation, mineralization, and osteogenic differentiation and inactivated the JNK/STAT3 pathway. Therefore, circSKIL may have a significant role in osteogenic differentiation and could serve as a potential target to prevent OPLL progression.
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Affiliation(s)
- Naikun Sun
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian 350122, P.R. China.,Department of Orthopedic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361005, P.R. China
| | - Yunbang Liang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361005, P.R. China
| | - Baoshan Hu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361005, P.R. China
| | - Jinyi Feng
- Department of Orthopedic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361005, P.R. China
| | - Guangxun Lin
- Department of Orthopedic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361005, P.R. China
| | - Xin Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361005, P.R. China
| | - Gang Rui
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian 350122, P.R. China.,Department of Orthopedic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361005, P.R. China
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Analysis of the Incompletely Hoisted Vertebrae in the Anterior Controllable Antedisplacement and Fusion Surgery: Causes and Prevention. Clin Spine Surg 2021; 34:125-131. [PMID: 32815852 DOI: 10.1097/bsd.0000000000001037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 04/24/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Anterior controllable antedisplacement and fusion (ACAF) has been reported to be a safe and effective technique. However, incompletely hoisted vertebrae (IV) were found in the postoperative images. This study aims to analyze the causes and prevention of IV. METHODS The ACAF-treated case series subjects were retrospectively reviewed. The vertebrae were separated into the IV group and completely hoisted vertebrae (CV) group according to the gap between the vertebrae and plate. The radiographic data, degree of cervical lordosis, bone mineral density, number of hoisted vertebrae, operative time, blood loss, and Japanese Orthopaedic Association score were compared between the patients with IV and the patients without IV. RESULTS A total of 248 vertebrae were hoisted in the enrolled patients. Intervertebral disc height in the IV group was 3.7±0.4 mm, which is significantly lower than that in the CV group. The anterior or posterior overhanging lip, osteoporosis, and oblique osteotomy troughs and hinges existing after osteotomy were found to be impingements preventing the hoisting of the vertebrae. There were no differences in the age, sex, degree of cervical lordosis, number of hoisted vertebrae, and neurological improvement rate between the groups of patients with and without IV. CONCLUSIONS Lower intervertebral space height and impingements preventing hoisting were found to be possible causes of IV in ACAF. Measures to prevent the problem should be carried out.
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Wang Y, Niu H, Liu Y, Yang H, Zhang M, Wang L. Promoting effect of long non-coding RNA SNHG1 on osteogenic differentiation of fibroblastic cells from the posterior longitudinal ligament by the microRNA-320b/IFNGR1 network. Cell Cycle 2020; 19:2836-2850. [PMID: 33017569 PMCID: PMC7714528 DOI: 10.1080/15384101.2020.1827188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 01/24/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) have been noted to influence the progression of ossification of posterior longitudinal ligament (OPLL). The work aims to probe the effect of lncRNA SNHG1 on osteogenic differentiation of ligament fibroblastic cells (LFCs). Aberrantly expressed lncRNAs in ossified PLL tissues were screened out by microarray analysis. Gain- and loss-of function experiments of SNHG1 were performed to identify its role in osteogenic differentiation of LFCs. The downstream molecules of SNHG1 were explored. Altered expression of miR-320b was introduced in LFCs as well. The interactions among SNHG1, miR-320b and IFNGR1 were identified. Consequently, SNHG1 was found highly expressed in OPLL patients. Silencing of SNHG1 inhibited BMP-2, RUNX2 and OCN expression and the ALP activity and reduced osteogenic differentiation of LFCs. Importantly, SNHG1 could and upregulate IFNGR1 through serving as a sponge for miR-320b. Over-expression of miR-320b inhibited osteogenic differentiation of LFCs and inactivated the JAK/STAT signaling pathway. Further administration of Fedratinib, a JAK2-specific agonist, increased osteogenic differentiation of LFCs. To conclude, the study suggested that SNHG1 could upregulate IFNGR1 by sequestering miR-320b and activate the JAK/STAT signaling. Silencing of SNHG1 could reduce the osteogenic differentiation and mineralization of LFCs. The study may offer new insights into OPLL treatment.
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Affiliation(s)
- Yuqiang Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Huixia Niu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Yilin Liu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Hao Yang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Min Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Limin Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China
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Li C, Zhou H, Yang S, Zhu X, Zha G, Yang Z, Yuan F, Jiang W. Effect of K-line on posterior cervical surgery in patients with posterior longitudinal ligament ossification. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:2368-2377. [PMID: 32564230 DOI: 10.1007/s00586-020-06507-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/14/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the effect of K-line on posterior single-door decompression with fusion fixation (PFF) and posterior single-door decompression with non-fusion fixation (PNF) for patients with ossification of posterior longitudinal ligament (OPLL). METHODS A total of 65 patients with OPLL were analyzed retrospectively. They consisted of 44 patients with positive K-line, designated as the K ( +) group, and 21 patients with negative K-line, designated as K (-). The patients were also divided into a PFF group (38 patients) and a PNF group (27 patients). The Japanese Orthopaedic Association (JOA) score, C2-C7 Cobb angle, improvement rate of JOA score, and complications were calculated and statistically analyzed between the groups. RESULTS In the K ( +) group, there were no significant differences in the incidence of C5 nerve root palsy and C2-C7 Cobb angle between the two groups of surgical patients, but there were significant differences in the improvement rate of JOA score and the incidence of axial pain. In the K (-) group, there were no significant differences in the incidence of axial pain, the incidence of C5 nerve root palsy, and preoperative C2-C7 Cobb angle between the two groups, but significant differences were observed in the improvement rate of JOA score and C2-C7 Cobb angle at the last follow-up. CONCLUSION In the K ( +) group, the improvement rate of JOA score was higher and the incidence of axial pain was lesser in the PNF group than in the PFF group. In the K (-) group, the improvement rate of JOA score was higher in the PFF group than in the PNF group, and there was significant loss of C2-C7 Cobb angle in the PNF group.
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Affiliation(s)
- Cheng Li
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 899, pinghai road, Suzhou, 215006, Jiangsu Province, China
| | - Hong Zhou
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 899, pinghai road, Suzhou, 215006, Jiangsu Province, China
| | - Sen Yang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 899, pinghai road, Suzhou, 215006, Jiangsu Province, China
| | - Xuanchen Zhu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 899, pinghai road, Suzhou, 215006, Jiangsu Province, China
| | - Guochun Zha
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu Province, China
| | - Zhi Yang
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu Province, China
| | - Feng Yuan
- Department of Orthopedics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu Province, China
| | - Weimin Jiang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, 899, pinghai road, Suzhou, 215006, Jiangsu Province, China.
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Sun J, Xu X, Wang Y, Yuan X, Shi J, Yang H, Guo Y, Kong Q, Wang Y, Sun K, Zhao Q. How to Avoid Postoperative Remaining Ossification Mass in Anterior Controllable Antedisplacement and Fusion Surgery. World Neurosurg X 2019; 3:100034. [PMID: 31225525 PMCID: PMC6584598 DOI: 10.1016/j.wnsx.2019.100034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/25/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives To retrospectively review the cases with ossification of the posterior longitudinal ligament (OPLL) treated with anterior controllable antedisplacement and fusion (ACAF). Patients with postoperative remaining ossification mass (PROM) are analyzed to figure out the causes and preventions of this problem. Methods A total of 115 patients were included. PROM was identified as remaining OPLL existed in the spinal canal other than included in the vertebral-OPLL complex on postoperative computed tomography. The Japanese Orthopaedic Association scoring system was used to evaluate the neurologic status. Surgery-related complications such as cerebrospinal fluid (CSF) leakage and spinal cord or nerve injury were all recorded. The patients with the PROM group and those without the PROM group were compared. Results There were 14 patients with wide-base OPLL (12.2%) and 10 patients (8.7%) with PROM among the 115 patients with OPLL. The 10 patients with PROM were all with wide-base OPLL. The average improvement rate of Japanese Orthopaedic Association score in patients without PROM was significantly larger than that in patients with PROM (69.5 ± 22.6% vs. 36.7 ± 22.0, P < 0.01). Incidence rate of postoperative CSF leakage and neural deterioration were significantly higher in patients with PROM than that in patients without PROM (CSF leakage, 40.0% vs. 5.9%; neural deterioration, 50.0% vs. 3.0%). No other complications were observed. Conclusions The occurrence of PROM might cause complications and poor neural function recovery in patients treated with ACAF. Surgical techniques should be noted to avoid PROM in ACAF surgery.
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Key Words
- ACAF, Anterior controllable antedisplacement and fusion
- Anterior controllable antedisplacement and fusion
- CSF, Cerebrospinal fluid
- CT, Computed tomography
- Complication
- IR, Improvement rate
- JOA, Japanese Orthopaedic Association
- MRI, Magnetic resonance imaging
- OPLL, Ossification of the posterior longitudinal ligament
- Ossification of the posterior longitudinal ligament
- PROM, Postoperative remaining ossification mass
- Postoperative remaining ossification mass
- VOC, Vertebral-OPLL complex
- WBO, Wide-base OPLL
- Wide-base OPLL
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Affiliation(s)
- Jingchuan Sun
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Ximing Xu
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Yuan Wang
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Xiaoqiu Yuan
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Jiangang Shi
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Haisong Yang
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Yongfei Guo
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Qingjie Kong
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Yingjie Wang
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Kaiqiang Sun
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
| | - Qingrong Zhao
- Second Department of Spine Surgery, Changzheng Hospital, Shanghai, China
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Yin M, Wang H, Ma J, Huang Q, Sun Z, Yan W, Ye J, Mo W. Radiological Characteristics and Surgical Outcome of Patients with Long Ossification of the Posterior Longitudinal Ligament Resulting in Ossified Lesions in the Upper Cervical Spine. World Neurosurg 2019; 127:e299-e310. [PMID: 30954753 DOI: 10.1016/j.wneu.2019.03.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/10/2019] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Designing surgical strategies for ossified lesions in the upper cervical spine is challenging owing to the complex anatomic structures. The present study aimed to clarify the prevalence of ossified lesions in the upper cervical spine in patients with ossification in the posterior longitudinal ligament and illustrate the clinical features, radiological findings, and surgical outcomes of this abnormality. METHODS Demographic and clinical data were collected for all patients preoperatively and included age, gender, body mass index, alcohol and tobacco use, history of diabetes, visual analog score, and Japanese Orthopaedic Association score. The cervical angle, morphology of ossification in the posterior longitudinal ligament, K-line, occupation ratio, space available for the spinal cord, high-intensity zone, and compression ratio of the spinal cord were calculated. The operative approach, technique used, and complications were recorded. RESULTS A total of 38 patients were enrolled. The upper cervical segment in 23 patients was not surgically addressed. In the group with the upper cervical segment addressed surgically, 10 patients were treated with C3-C6 open-door laminoplasty and C2 partial laminectomy, 1 with C1-C7 laminoplasty, 1 with C2-C7 laminoplasty, 2 with C3-C6 total and C2 partial laminectomy, and 1 with C1-C5 laminectomy and occipitocervical fusion. CONCLUSIONS The development of ossified lesions in the upper cervical spine has a high incidence. Decompressive surgery for upper cervical spine segments should be recommended for patients with severe narrowing of the spinal canal and a high signal intensity that extends to the upper cervical segment of the spinal cord. We hope that the findings from the present study will aid in clinical decision-making and provide useful information that can be incorporated into future guidelines.
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Affiliation(s)
- Mengchen Yin
- Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongshen Wang
- Division of Spine Center, Second Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Junming Ma
- Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Quan Huang
- Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Zhengwang Sun
- Department of Musculoskeletal Oncology, Fudan University Cancer Center, Shanghai, China
| | - Wangjun Yan
- Department of Musculoskeletal Oncology, Fudan University Cancer Center, Shanghai, China
| | - Jie Ye
- Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen Mo
- Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Sun JC, Sun KQ, Sun SX, Xu XM, Wang Y, Kong QJ, Yang HS, Guo YF, Shi GD, Shi JG. Computer-assisted virtual operation planning in anterior controllable anterior-displacement and fusion surgery for ossification of the posterior longitudinal ligament based on actual computed tomography data. Clin Neurol Neurosurg 2018; 177:86-91. [PMID: 30634057 DOI: 10.1016/j.clineuro.2018.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/17/2018] [Accepted: 12/28/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To investigate the effect of computer-assisted virtual operation planning (CAVOP) on anterior controllable anterior-displacement and fusion (ACAF) surgery for ossification of the posterior longitudinal ligament (OPLL). PATIENTS AND METHODS A total of 25 patients with OPLL were enrolled in the study from September 2017 to December 2017. Preoperative Computed tomography (CT) scanning data were input into Mimics software to reconstruct three-dimensional (3D) models of actual cervical OPLL.Preoperative simulation of each surgical procedure and measurement of main parameters for intraoperative decision were conducted. Postoperative CT were used to test the clinical value of the preoperative planning. Width of vertebrae-OPLL complex (VOC), thickness of resected vertebral body (VB), height of intervertebral spacer, and length of screws and anterior plate were analyzed. RESULTS There were no significant differences between the length of screws, width of VOC, and thickness of anterior resection of vertebrae in preoperative CT and postoperative CT. Statistical differences were found between preoperative and postoperative height of intervertebral space and length of anterior plate. CONCLUSION A virtual ACAF surgical procedure for OPLL is feasible and useful clinically in surgical planning. It may provide a valuable tool for surgeons in formulating an appropriate surgical plan.
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Affiliation(s)
- Jing-Chuan Sun
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China
| | - Kai-Qiang Sun
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China
| | - Shuang-Xi Sun
- Department of Spine Surgery, Weihai Central Hospital, Shandong, China
| | - Xi-Ming Xu
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China
| | - Yuan Wang
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China
| | - Qing-Jie Kong
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China
| | - Hai-Song Yang
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China
| | - Yong-Fei Guo
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China
| | - Guo-Dong Shi
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China.
| | - Jian-Gang Shi
- Department of Orthopedic Surgery,Spine Center,Changzheng Hospital, Second Military Medical University No.415 Fengyang Road, Shanghai 200003,People's Republic of China.
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Anterior Controllable Antedisplacement and Fusion as Revision Surgery After Posterior Decompression Surgery in Patients with Ossification of the Posterior Longitudinal Ligament. World Neurosurg 2018; 123:e310-e317. [PMID: 30496921 DOI: 10.1016/j.wneu.2018.11.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/16/2018] [Accepted: 11/18/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the surgical outcomes of anterior controllable antedisplacement and fusion (ACAF) as a revision surgery after posterior decompression surgery (PDS) in patients with ossification of the posterior longitudinal ligament (OPLL). METHODS From June 2016 to May 2017, 15 patients (7 men; 8 women) had undergone ACAF as revision after PDS. The Japanese Orthopaedic Association (JOA) score was used to evaluate the pre- and postoperative neurological function. The kappa line and complications were also evaluated. RESULTS The 15 patients were followed up for 15.1 ± 1.8 months (range, 12-18). The mean interval between the initial PDS and revision ACAF was 40.3 ± 11.3 months (range, 24-62). The JOA score improved from 8.9 ± 1.6 (range, 5-11) before revision ACAF to 13.9 ± 1.6 (range, 11-16) at the final follow-up evaluation (P < 0.05). The JOA recovery rate was 61.9% ± 15.8% (range, 37.5%-90.9%). The kappa line of 7 patients improved from negative values to positive values after ACAF. Five complications (33.3%) developed in 5 patients. No instrument failure or neurological deterioration was observed during the follow-up period. CONCLUSION In the present study, the outcomes of ACAF for revision surgery for OPLL were satisfactory. ACAF could improve neurological function significantly and is an alternative surgical procedure for revision of PDS for OPLL.
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Anterior Controllable Antedisplacement Fusion as a Choice for Degenerative Cervical Kyphosis with Stenosis: Preliminary Clinical and Radiologic Results. World Neurosurg 2018; 118:e562-e569. [DOI: 10.1016/j.wneu.2018.06.239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 11/18/2022]
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