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Comparison of surgical outcomes of posterior surgeries between cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament

Abstract

Study design

Retrospective multicenter study.

Objective

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).

Setting

Seventeen medical institutions in Japan.

Methods

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.

Results

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.

Conclusion

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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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

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.

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Authors

Contributions

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.

Corresponding authors

Correspondence to Narihito Nagoshi or Junichi Yamane.

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Competing interests

The authors declare no competing interests.

Ethics approval

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 60, 928–933 (2022). https://doi.org/10.1038/s41393-022-00848-0

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