Journal of Clinical Medicine (Nov 2022)
Prospective Investigation of Surgical Outcomes after Anterior Decompression with Fusion and Laminoplasty for the Cervical Ossification of the Posterior Longitudinal Ligament: A Propensity Score Matching Analysis
- Toshitaka Yoshii,
- Shingo Morishita,
- Satoru Egawa,
- Kenichiro Sakai,
- Kazuo Kusano,
- Shunji Tsutsui,
- Takashi Hirai,
- Yu Matsukura,
- Kanichiro Wada,
- Keiichi Katsumi,
- Masao Koda,
- Atsushi Kimura,
- Takeo Furuya,
- Satoshi Maki,
- Narihito Nagoshi,
- Norihiro Nishida,
- Yukitaka Nagamoto,
- Yasushi Oshima,
- Kei Ando,
- Hiroaki Nakashima,
- Masahiko Takahata,
- Kanji Mori,
- Hideaki Nakajima,
- Kazuma Murata,
- Masayuki Miyagi,
- Takashi Kaito,
- Kei Yamada,
- Tomohiro Banno,
- Satoshi Kato,
- Tetsuro Ohba,
- Satoshi Inami,
- Shunsuke Fujibayashi,
- Hiroyuki Katoh,
- Haruo Kanno,
- Hiroshi Taneichi,
- Shiro Imagama,
- Yoshiharu Kawaguchi,
- Katsushi Takeshita,
- Morio Matsumoto,
- Masashi Yamazaki,
- Atsushi Okawa
Affiliations
- Toshitaka Yoshii
- Department of Orthopedic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- Shingo Morishita
- Department of Orthopedic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- Satoru Egawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- Kenichiro Sakai
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Saitama 332-8558, Japan
- Kazuo Kusano
- Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyadaku 102-0074, Japan
- Shunji Tsutsui
- Department of Orthopaedic Surgery, Faculty of Medicine, Wakayama Medical University, Wakayama 641-8510, Japan
- Takashi Hirai
- Department of Orthopedic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- Yu Matsukura
- Department of Orthopedic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- Kanichiro Wada
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Aomori 036-8562, Japan
- Keiichi Katsumi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata 951-8520, Japan
- Masao Koda
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
- Atsushi Kimura
- Department of Orthopedics, Faculty of medicine, Jichi Medical University, Tochigi 329-0498, Japan
- Takeo Furuya
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba 260-0856, Japan
- Satoshi Maki
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba 260-0856, Japan
- Narihito Nagoshi
- Department of Orthopaedic Surgery, School of Medicine, Faculty of Medicine, Keio University, Tokyo 160-8582, Japan
- Norihiro Nishida
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Yamaguchi 755-8505, Japan
- Yukitaka Nagamoto
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Osaka 591-8025, Japan
- Yasushi Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
- Kei Ando
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan
- Hiroaki Nakashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan
- Masahiko Takahata
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
- Kanji Mori
- Department of Orthopaedic Surgery, Faculty of Medicine, Shiga University of Medical Science, Shiga 520-2192, Japan
- Hideaki Nakajima
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
- Kazuma Murata
- Department of Orthopedic Surgery, Faculty of Medicine, Tokyo Medical University, Tokyo 160-0023, Japan
- Masayuki Miyagi
- Department of Orthopedic Surgery, Faculty of Medicine, Kitasato University Hospital, Kanagawa 252-0375, Japan
- Takashi Kaito
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Kei Yamada
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Fukuoka 830-0011, Japan
- Tomohiro Banno
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3125, Japan
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8641, Japan
- Tetsuro Ohba
- Department of Orthopedic Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
- Satoshi Inami
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan
- Shunsuke Fujibayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
- Hiroyuki Katoh
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa 259-1193, Japan
- Haruo Kanno
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Miyagi 980-8574, Japan
- Hiroshi Taneichi
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan
- Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Aichi 466-8550, Japan
- Yoshiharu Kawaguchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan
- Katsushi Takeshita
- Department of Orthopedics, Faculty of medicine, Jichi Medical University, Tochigi 329-0498, Japan
- Morio Matsumoto
- Department of Orthopaedic Surgery, School of Medicine, Faculty of Medicine, Keio University, Tokyo 160-8582, Japan
- Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
- Atsushi Okawa
- Department of Orthopedic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
- DOI
- https://doi.org/10.3390/jcm11237012
- Journal volume & issue
-
Vol. 11,
no. 23
p. 7012
Abstract
The ideal surgical strategy for cervical ossification of the posterior longitudinal ligament (OPLL) remains controversial due to the lack of high-quality evidence. Herein, we prospectively investigated the surgical outcomes of anterior cervical decompression with fusion (ADF) and laminoplasty (LAMP) with cervical OPLL. Three hundred patients were included in this study (ADF: n = 89; LAMP: n = 211 patients), and propensity score matching yielded 67 pairs of patients with ADF and LAMP, in which clinical outcomes were compared. Crude analysis revealed that the ADF group showed greater neurological recovery in cervical Japanese Orthopedic Association scores at two years, compared with that in the LAMP group (53.1% vs. 44.3%, p = 0.037). The ratio of minimum clinically important difference (MCID) success was significantly greater in the ADF group (59.6% vs. 43.6%, p = 0.016). Multivariate analysis showed that the factors affecting MCID success were age, body mass index, duration of symptoms, and choice of ADF. In the 1:1 matched analysis, neurological improvement was more favorable in the ADF group (57.2%) compared to the LAMP group (46.8%) at two years (p = 0.049). However, perioperative complications, such as dysphagia and graft-related complications, were more common in the ADF group.
Keywords
- ossification of the posterior longitudinal ligament
- anterior decompression and fusion
- laminoplasty
- propensity score matching
- neurological recovery
- minimum clinically important difference
