Comparison of C2 dome-like laminectomy with C2 partial laminectomy for upper cervical ossification of the posterior longitudinal ligament

Objective: To compare surgical outcomes of C2 dome-like laminectomy with C2 partial laminectomy in patients with ossification of the posterior longitudinal ligament (OPLL) up to the C2 level and above. Methods: = 16). The cervical curvature (CCI), dura width at C2/3, Japanese orthopedic association (JOA) score, recovery rate (RR), neck disability index (NDI) score, and visual analogue scale (VAS) score were evaluated and compared preoperatively and postoperatively at 1 month, 3 months, 6 months, 1 year, and annually thereafter. Results: The JOA score and NDI significantly improved at the final follow-up in both groups with no significant intergroup differences. There were no significant differences in preoperative dura width at C2/3 and VAS between the two groups. At the final follow-up, dura width at C2/3 in the C2-PL group was significantly larger than the C2-DOM group, while the VAS of C2-DOM group was significantly lower than C2-PL group. The CCI in both groups decreased compared with before surgery, and there was no significant difference in CCI between the two groups. Conclusion: C2-DOM is less demolitive and reduces postoperative neck pain, while C2-PL can achieve more adequate decompression without increasing the risk of postoperative cervical kyphosis.