One-stage posterior LFF is Efficient for relieving Radiculop
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This study aimed to explore the clinical efficacy of posterior LFF (laminectomy with instrumented fusion and foraminotomy) for cervical Ossification of the posterior longitudinal ligament (OPLL) with radicular pain of upper limbs.

A retrospective examination of 48 OPLL patients with radicular pain complaints in the upper limbs who underwent a one-stage posterior laminectomy and instrumented fusion with/without foraminotomy were reviewed retrospectively and divided into two groups:
1) LF group (laminectomy with instrumented fusion without foraminotomy) and
2) LFF group .

Clinical data were assessed and compared between the two groups. The radicular pain of upper limbs and neck was measured using the visual analog scale (VAS). The neurological function was evaluated with the American Spinal Injury Association (ASIA) scale. Changes of sagittal alignment were investigated by postoperative plain x-ray or computed tomography (CT). Moreover, the decompression of the spinal cord was evaluated based on postoperative MRI.

Results:
--All the 48 patients were followed up for 24–42 months with an average follow-up time of 31.1±5.3 months.

--A total of 56 cervical intervertebral foramens were enlarged in 48 patients, including 40 cases with 1 intervertebral foramen enlargement and 8 cases with 2 intervertebral foramen enlargements.

--There were no significant differences in intraoperative blood loss, postoperative drainage amount, Japanese Orthopaedic Association (JOA) scores, JOA recovery rates, VAS scores for neck pain, and ASIA grade between two groups.

--The mean operative time was shorter in the LF group compared with the LFF group.

--The VAS score for arm pain was significantly lower while the surgical duration was longer in group B.

--No statistical difference was observed between the two groups in terms of C2–C7 SVA, cervical lordosis, focal angulation at the foraminotomy segment, and local spinal cord angle.

--Compared with the LF group, there was no segmental kyphosis or instability where the additional posterior foraminotomy was performed in the LFF group.

Conclusively, One-stage posterior LFF can achieve satisfied clinical efficacy in improving neurological function and relieving the radicular pain of the upper limbs for OPLL patients with radiculopathy symptoms.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02431-4
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