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Application of the "Klotski Technique" in Cervical Ossification of the Posterior Longitudinal Ligament With En Bloc Type Dura Ossification

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机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, 45 Changchun St, Beijing 100053, Peoples R China [2]China Int Neurosci Inst CHINA INI, Spine Ctr, Beijing, Peoples R China [3]Capital Med Univ, Beijing Inst Brain Disorders, Res Ctr Spine & Spinal Cord, Beijing, Peoples R China [4]Natl Ctr Neurol Disorders, Beijing, Peoples R China [5]China Int Neurosci Inst CHINA INI, Lab Spinal Cord Injury & Funct Reconstruct, Beijing, Peoples R China
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关键词: Anterior corpectomy and fusion Dural ossification Hook sign Ossification of the posterior longitudinal ligament Anterior controllable antedisplacement fusion Anterior corpectomy and fusion Cerebrospinal fluid leakage

摘要:
Objective: The anterior controllable antedisplacement and fusion (ACAF) technique is a new procedure for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) that requires management of the disc adjacent to the ossification. This study describes a novel technique to reduce the number of fixed segments, namely, the "Klotski technique." The efficacy of ACAF using the Klotski technique was compared with that of anterior cervical corpectomy and fusion (ACCF) in the treatment of OPLL with en bloc type dural ossification (DO). Methods: The clinical data of 25 patients with severe OPLL and en bloc type DO who were treated by the ACAF Klotski technique or ACCF at our hospital from January 2020 to January 2022 were retrospectively analyzed. In the Klotski technique, the number of segments fused within the OPLL is limited. The antedisplacement space was designed according to the shape of the vertebrae-OPLL-DO complex (VODC). Then, the entire VODC was antedisplaced as in Klotski. Neurological function and image examination were assessed preoperatively and postoperatively. Complications associated with surgery were recorded. Results: Patients were followed up for 24-36 months. There were 11 patients who were treated with ACAF and 14 patients who were treated with ACCF. At 2 weeks after surgery, the incidence of neurological deterioration was 21.4% (3 of 14) in the ACCF group and 9.1% (1 of 11) in the ACAF group. The incidence of intraoperative cerebrospinal fluid leakage (CFL) was 35.7% (5 of 14) in the ACCF group and 9.1% (1 of 11) in the ACAF group. The postoperative follow-up JOA scores of the patients in both groups were significantly better Conclusion: The Klotski technique for ACAF is a good option for the treatment of patients with en bloc type OPLL-DO, as it limits the number of fused segments, has a low incidence of CFL and neurologic deficits and is associated with good neurological recovery.

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出版当年[2023]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 外科
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 外科
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出版当年[2022]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 SURGERY

影响因子: 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

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第一作者机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, 45 Changchun St, Beijing 100053, Peoples R China [2]China Int Neurosci Inst CHINA INI, Spine Ctr, Beijing, Peoples R China [3]Capital Med Univ, Beijing Inst Brain Disorders, Res Ctr Spine & Spinal Cord, Beijing, Peoples R China [4]Natl Ctr Neurol Disorders, Beijing, Peoples R China [5]China Int Neurosci Inst CHINA INI, Lab Spinal Cord Injury & Funct Reconstruct, Beijing, Peoples R China
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通讯机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, 45 Changchun St, Beijing 100053, Peoples R China [2]China Int Neurosci Inst CHINA INI, Spine Ctr, Beijing, Peoples R China [3]Capital Med Univ, Beijing Inst Brain Disorders, Res Ctr Spine & Spinal Cord, Beijing, Peoples R China [4]Natl Ctr Neurol Disorders, Beijing, Peoples R China [5]China Int Neurosci Inst CHINA INI, Lab Spinal Cord Injury & Funct Reconstruct, Beijing, Peoples R China
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