Issue release date: 12.11.2024
2Kyungpook National University Hospital, Kyungpook National University School of Medicine, Department of Neurosurgery, Daegu, Korea
3Asan Medical Center, University of Ulsan College of Medicine, Department of Neurosurgery, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea DOI : 10.5137/1019-5149.JTN.31668-20.1 AIM: To evaluate the usefulness of the rostral line (R-line) as a new index for determining the degree of C2 lamina decompression in the context of ossification of the posterior longitudinal ligament (OPLL) extending to the C2 level.
MATERIAL and METHODS: The R-line was devised based on the mechanism by which the cord is shifted backward following cervical posterior decompression. According to their R-line status, 36 patients with cervical OPLL extending to the C2 level were divided into two groups of R-line (+) and R-line (?) cases, where the R-line touched the upper half of the posterior C2 lamina in the R-line (+) group and the inferior half of the posterior C2 lamina in the R-line (?) group, respectively.
RESULTS: Eighteen patients were classified as R-line (+) and 18 patients were classified as R-line (?). Total laminectomy of the C2 lamina was more common in the R-line (+) group, while dome-shape C2 laminectomy was more common in the R-line (?) group. All patients requiring reoperation were included in the R-line (+) group. Only the operation type showed a statistically significant difference according to the need for reoperation in the R-line (+) group; specifically, all patients who underwent reoperation in the R-line (+) group had dome-shape C2 laminectomy. It was determined that the risk factor for reoperation in the R-line (+) group was a history of dome-shape C2 laminectomy.
CONCLUSION: If the R-line touches the upper half of the posterior C2 lamina, total decompression of the C2 lamina should be performed.
Keywords : Axis, Cervical vertebra, Laminectomy, Ossification of the posterior longitudinal ligament, Posterior decompression, R-line