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

• Published in: Spinal cord Vol. 60; no. 10; pp. 928 - 933
• Main Authors: Nori, Satoshi, Nagoshi, Narihito, Daimon, Kenshi, Ikegami, Takeshi, Funao, Haruki, Nojiri, Kenya, Takahashi, Yuichiro, Fukuda, Kentaro, Suzuki, Satoshi, Takahashi, Yohei, Tsuji, Osahiko, Yagi, Mitsuru, Nakamura, Masaya, Matsumoto, Morio, Watanabe, Kota, Ishii, Ken, Yamane, Junichi
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-10-2022; Nature Publishing Group
• Subjects: 692/308/409; 692/699/375/1824; Anatomy; Biomedical and Life Sciences; Biomedicine; Body mass; Body mass index; Body size; Central nervous system diseases; Complications; Decompression; Health care facilities; Human Physiology; Ligaments; Matching; Neck pain; Neurochemistry; Neurological complications; Neuropsychology; Neurosciences; Orthopedics; Ossification; Pain; Spinal cord; Stenosis; Surgery; Surgical outcomes
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/s41393-022-00848-0

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.