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Spinal Cord (2022 )Cite this article
To compare the surgical outcomes and complications of posterior decompression between individuals with cervical spondylotic myelopathy (CSM) and those with ossification of the posterior longitudinal ligament (OPLL).
Seventeen medical institutions in Japan.
This study included 814 individuals with CSM (n = 636) and OPLL (n = 178) who underwent posterior decompression. Propensity score matching of the baseline characteristics was performed to compare surgical outcomes and perioperative complications between the CSM and OPLL groups.
Before propensity score matching, the OPLL group had higher percentage of male individuals, body mass index, and number of stenosis levels and longer duration of symptoms (P < 0.01, P < 0.01, P < 0.01, and P < 0.01, respectively). After matching, the baseline characteristics were comparable between the CSM (n = 98) and OPLL (n = 98) groups. The postoperative Japanese Orthopaedic Association (JOA) scores, preoperative-to-postoperative changes in the JOA scores, and JOA score recovery rates were not significantly different between the groups (P = 0.42, P = 0.47, and P = 0.09, respectively). The postoperative visual analog scale (VAS) score for neck pain and preoperative-to-postoperative changes in the VAS score for neck pain were not significantly different between the groups (P = 0.25 and P = 0.50, respectively). The incidence of perioperative complications was comparable between groups.
Neurological improvement and complication rates after surgery were comparable between individuals with CSM and those with OPLL, suggesting similar effectiveness and safety of posterior decompression for both conditions.
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The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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The authors thank Takahito Iga, MD, Ryoma Aoyama, MD, PhD, Norihiro Isogai, MD, PhD, Kazuki Takeda, MD, PhD, Morito Takano, MD, PhD, Masahiro Ozaki, MD, PhD, Takeshi Fujii, MD, PhD, Soraya Nishimura, MD, PhD and the members of the 17 participating institutions for their help with data collection.
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
Satoshi Nori, Narihito Nagoshi, Satoshi Suzuki, Yohei Takahashi, Osahiko Tsuji, Mitsuru Yagi, Masaya Nakamura, Morio Matsumoto & Kota Watanabe
Keio Spine Research Group (KSRG), Tokyo, Japan
Satoshi Nori, Narihito Nagoshi, Kenshi Daimon, Takeshi Ikegami, Haruki Funao, Kenya Nojiri, Yuichiro Takahashi, Kentaro Fukuda, Satoshi Suzuki, Yohei Takahashi, Osahiko Tsuji, Mitsuru Yagi, Masaya Nakamura, Morio Matsumoto, Kota Watanabe, Ken Ishii & Junichi Yamane
Department of Orthopaedic Surgery, Ogikubo Hospital, Tokyo, Japan
Department of Orthopaedic Surgery, Saitama Medical Center, Saitama, Japan
Department of Orthopaedic Surgery, Fussa Hospital, Tokyo, Japan
Spine and Spinal cord Center, International University of Health and Welfare (IUHW) Mita Hospital, Tokyo, Japan
Haruki Funao & Ken Ishii
Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba, Japan
Haruki Funao & Ken Ishii
Department of Orthopaedic Surgery, Isehara Kyodo Hospital, Kanagawa, Japan
Department of Orthopaedic Surgery, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
Yuichiro Takahashi & Kentaro Fukuda
Department of Orthopaedic Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
Department of Orthopaedic Surgery, National Hospital Organization Murayama Medical Center, Tokyo, Japan
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SN and NN designed the research. SN analyzed the data. SN and NN wrote the paper. SN, KD, TI, HF, KN, YT, and KF performed data collection. NN, SS, YT, OT, MY, MN, MM, KW, KI, and JY supervised the study. All authors reviewed and approved the paper.
Correspondence to Narihito Nagoshi or Junichi Yamane.
The authors declare no competing interests.
This study received ethical approval from the institutional review boards of the participating institutions. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
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Nori, S., Nagoshi, N., Daimon, K. et al. Comparison of surgical outcomes of posterior surgeries between cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. Spinal Cord (2022). https://doi.org/10.1038/s41393-022-00848-0
DOI: https://doi.org/10.1038/s41393-022-00848-0
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Spinal Cord (Spinal Cord) ISSN 1476-5624 (online) ISSN 1362-4393 (print)