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Comparison of the Therapeutic Effects of Anterior and Posterior Decompression and Fusion in the Treatment of Patients with Ossification of the Posterior Longitudinal Ligament of the Cervical Spine |
CHANG Yuewen, ZHU Wenjun, FENG Juntao, et al |
Department of Orthopedics, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200001 |
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Abstract 【Objective】To compare the efficacy of anterior and posterior decompression and fusion in the treatment of patients with ossification of the posterior longitudinal ligament of the cervical spine (OPLL). 【Methods】A total of 97 patients with ossification of the posterior longitudinal ligament of the cervical spine admitted to the orthopedics department of our hospital from January 2021 to December 2023 were selected and randomly divided into the control group (receiving posterior decompression and fusion surgery, n=48) and the observation group (receiving anterior decompression and fusion surgery, n=49) according to the envelope lottery method. The surgery-related indicators (blood loss, operation time, postoperative drainage volume, hospital stay, hospitalization cost), functional recovery [Cervical Disability Index (NDI), Japanese Orthopaedic Association (JOA) score], C2-7 Angle, C2-7 sagittal plane vertical distance, and the occurrence of postoperative complications were compared between the two groups. 【Results】The amount of bleeding, postoperative drainage volume and hospitalization cost in the observation group were all less than those in the control group, while the operation time and hospital stay were shorter than those in the control group. One week and three months after the operation, the NDI scores of both groups were lower than those before the operation (P<0.05), and the NDI scores of the observation group was lower than those of the control group (P<0.05). One week and three months after the operation, the JOA scores of both groups were higher than those before the operation (P<0.05), and the scores of the observation group was higher than those of the control group (P<0.05). Three months after the operation, the C2-7 angles in both groups improved significantly, and the angle in the observation group was greater than that in the control group. Three months after the operation, the sagittal plane vertical distance of C2-7 in both groups was significantly shorter than that before the operation, and the distance in the observation group was shorter than that in the control group. The difference was statistically significant (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). 【Conclusion】Anterior decompression-fusion is superior to posterior decompression and fusion in improving the function and structural adjustment of patients with ossification of the posterior longitudinal ligament of the cervical spine. And anterior decompression and fusion has better safety.
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Received: 18 April 2024
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