The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study
Abstract Study design A retrospective study. Objectives This study aims to investigate the relationship between the resection of ossification of the nuchal ligament (ONL), its morphological features, and cervical stability following modified laminoplasty. Methods We retrospectively reviewed the data...
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BMC
2025-05-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08729-2 |
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| author | Chong Chen Wenlin Ye Tao Yu Xing Cheng Lutong Wang Xingchen Zhao Xiang Long Jun Ouyang Yunbing Chang Xiaoqing Zheng |
| author_facet | Chong Chen Wenlin Ye Tao Yu Xing Cheng Lutong Wang Xingchen Zhao Xiang Long Jun Ouyang Yunbing Chang Xiaoqing Zheng |
| author_sort | Chong Chen |
| collection | DOAJ |
| description | Abstract Study design A retrospective study. Objectives This study aims to investigate the relationship between the resection of ossification of the nuchal ligament (ONL), its morphological features, and cervical stability following modified laminoplasty. Methods We retrospectively reviewed the data of patients diagnosed as degenerative cervical myelopathy (DCM) who underwent modified laminoplasty with muscle-ligament complex (MLC) reconstruction in our hospital between July 2018 and October 2022. Demographic information (e.g., age, gender), cervical sagittal parameters, cervical angular displacement (AD), cervical horizontal displacement (HD), range of motion and patient-reported outcomes were compared between patients with and without ONL. Results The cervical AD at C4-C5, C5-C6 and cervical HD at C5-6 were significantly higher in ONL (+) group than ONL (-) group before surgery and at the 24-month follow-up time (p < 0.05, all). The AD and HD at C4-C5 and C5-C6 were higher in ONL (+) segments before surgery and at the 24-month follow-up (p < 0.05, all). But the values of AD or HD were lower in ONL (+) segments at 3- or 6-month follow-up (p < 0.05, all). ONL (+) group with two or more consecutive segments demonstrate significantly increased cervical AD and HD at the C4-C5 level after a 24-month follow-up period (p < 0.01, both). Conclusion Resection of the ONL, particularly involving ≥ 2 cervical segments, is moderately associated with an increased likelihood of cervical instability and abnormal sagittal alignment in long-term follow-up after laminoplasty. Reconstruction of the MLC during laminoplasty may enhance cervical stability in the early follow-up period. For DCM patients with long segmental ONL, more attention should be paid to protecting the MLC structure during posterior cervical surgery. Clinical trial number Not applicable. |
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| institution | OA Journals |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-d817f6a14bbb474f9a31575414c1a8c22025-08-20T01:52:23ZengBMCBMC Musculoskeletal Disorders1471-24742025-05-0126111310.1186/s12891-025-08729-2The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up studyChong Chen0Wenlin Ye1Tao Yu2Xing Cheng3Lutong Wang4Xingchen Zhao5Xiang Long6Jun Ouyang7Yunbing Chang8Xiaoqing Zheng9Department of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangdong Provincial Key Laboratory of Medical Biomechanics & Guangdong Engineering Research Center for Translation of Medical 3D Printing Application & National Virtual & Reality Experimental Education Center for Medical Morphology & National Experimental Education Demonstration Center for Basic Medical Sciences, National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Spine Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityAbstract Study design A retrospective study. Objectives This study aims to investigate the relationship between the resection of ossification of the nuchal ligament (ONL), its morphological features, and cervical stability following modified laminoplasty. Methods We retrospectively reviewed the data of patients diagnosed as degenerative cervical myelopathy (DCM) who underwent modified laminoplasty with muscle-ligament complex (MLC) reconstruction in our hospital between July 2018 and October 2022. Demographic information (e.g., age, gender), cervical sagittal parameters, cervical angular displacement (AD), cervical horizontal displacement (HD), range of motion and patient-reported outcomes were compared between patients with and without ONL. Results The cervical AD at C4-C5, C5-C6 and cervical HD at C5-6 were significantly higher in ONL (+) group than ONL (-) group before surgery and at the 24-month follow-up time (p < 0.05, all). The AD and HD at C4-C5 and C5-C6 were higher in ONL (+) segments before surgery and at the 24-month follow-up (p < 0.05, all). But the values of AD or HD were lower in ONL (+) segments at 3- or 6-month follow-up (p < 0.05, all). ONL (+) group with two or more consecutive segments demonstrate significantly increased cervical AD and HD at the C4-C5 level after a 24-month follow-up period (p < 0.01, both). Conclusion Resection of the ONL, particularly involving ≥ 2 cervical segments, is moderately associated with an increased likelihood of cervical instability and abnormal sagittal alignment in long-term follow-up after laminoplasty. Reconstruction of the MLC during laminoplasty may enhance cervical stability in the early follow-up period. For DCM patients with long segmental ONL, more attention should be paid to protecting the MLC structure during posterior cervical surgery. Clinical trial number Not applicable.https://doi.org/10.1186/s12891-025-08729-2Ossification of the nuchal ligament (ONL)Degenerative cervical myelopathy (DCM)LaminoplastyCervical stabilityMuscle-ligament complex (MLC) |
| spellingShingle | Chong Chen Wenlin Ye Tao Yu Xing Cheng Lutong Wang Xingchen Zhao Xiang Long Jun Ouyang Yunbing Chang Xiaoqing Zheng The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study BMC Musculoskeletal Disorders Ossification of the nuchal ligament (ONL) Degenerative cervical myelopathy (DCM) Laminoplasty Cervical stability Muscle-ligament complex (MLC) |
| title | The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study |
| title_full | The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study |
| title_fullStr | The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study |
| title_full_unstemmed | The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study |
| title_short | The impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty: a long-term follow-up study |
| title_sort | impact of nuchal ligament ossification resection on cervical stability after modified laminoplasty a long term follow up study |
| topic | Ossification of the nuchal ligament (ONL) Degenerative cervical myelopathy (DCM) Laminoplasty Cervical stability Muscle-ligament complex (MLC) |
| url | https://doi.org/10.1186/s12891-025-08729-2 |
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