Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament
Abstract This prospective multicenter study, established by the Japanese Ministry of Health, Labour and Welfare and involving 27 institutions, aimed to compare postoperative outcomes between laminoplasty (LM) and posterior fusion (PF) for cervical ossification of the posterior longitudinal ligament...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-01-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-04727-1 |
| _version_ | 1819008501251309568 |
|---|---|
| author | Hiroaki Nakashima Shiro Imagama Toshitaka Yoshii Satoru Egawa Kenichiro Sakai Kazuo Kusano Yukihiro Nakagawa Takashi Hirai Kanichiro Wada Keiichi Katsumi Kengo Fujii Atsushi Kimura Takeo Furuya Tsukasa Kanchiku Yukitaka Nagamoto Yasushi Oshima Narihito Nagoshi Kei Ando Masahiko Takahata Kanji Mori Hideaki Nakajima Kazuma Murata Shunji Matsunaga Takashi Kaito Kei Yamada Sho Kobayashi Satoshi Kato Tetsuro Ohba Satoshi Inami Shunsuke Fujibayashi Hiroyuki Katoh Haruo Kanno Yuanying Li Hiroshi Yatsuya Masao Koda Yoshiharu Kawaguchi Katsushi Takeshita Morio Matsumoto Masashi Yamazaki Atsushi Okawa Japanese Multicenter Research Organization for Ossification of the Spinal Ligament |
| author_facet | Hiroaki Nakashima Shiro Imagama Toshitaka Yoshii Satoru Egawa Kenichiro Sakai Kazuo Kusano Yukihiro Nakagawa Takashi Hirai Kanichiro Wada Keiichi Katsumi Kengo Fujii Atsushi Kimura Takeo Furuya Tsukasa Kanchiku Yukitaka Nagamoto Yasushi Oshima Narihito Nagoshi Kei Ando Masahiko Takahata Kanji Mori Hideaki Nakajima Kazuma Murata Shunji Matsunaga Takashi Kaito Kei Yamada Sho Kobayashi Satoshi Kato Tetsuro Ohba Satoshi Inami Shunsuke Fujibayashi Hiroyuki Katoh Haruo Kanno Yuanying Li Hiroshi Yatsuya Masao Koda Yoshiharu Kawaguchi Katsushi Takeshita Morio Matsumoto Masashi Yamazaki Atsushi Okawa Japanese Multicenter Research Organization for Ossification of the Spinal Ligament |
| author_sort | Hiroaki Nakashima |
| collection | DOAJ |
| description | Abstract This prospective multicenter study, established by the Japanese Ministry of Health, Labour and Welfare and involving 27 institutions, aimed to compare postoperative outcomes between laminoplasty (LM) and posterior fusion (PF) for cervical ossification of the posterior longitudinal ligament (OPLL), in order to address the controversy surrounding the role of instrumented fusion in cases of posterior surgical decompression for OPLL. 478 patients were considered for participation in the study; from among them, 189 (137 and 52 patients with LM and PF, respectively) were included and evaluated using the Japanese Orthopaedic Association (JOA) scores, the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and radiographical measurements. Basic demographic and radiographical data were reviewed, and the propensity to choose a surgical procedure was calculated. Preoperatively, there were no significant differences among the participants in terms of patient backgrounds, radiographical measurements (K-line or cervical alignment on X-ray, OPLL occupation ratio on computed tomography, increased signal intensity change on magnetic resonance imaging), or clinical status (JOA score and JOACMEQ) after adjustments. The overall risk of perioperative complications was found to be lower with LM (odds ratio [OR] 0.40, p = 0.006), and the rate of C5 palsy occurrence was significantly lower with LM (OR 0.11, p = 0.0002) than with PF. The range of motion (20.91° ± 1.05° and 9.38° ± 1.24°, p < 0.0001) in patients who had PF was significantly smaller than in those who had LM. However, multivariable logistic regression analysis showed no significant difference among the participants in JOA score, JOA recovery rate, or JOACMEQ improvement at two years. In contrast, OPLL progression was greater in the LM group than in the PF group (OR 2.73, p = 0.0002). Both LM and PF for cervical myelopathy due to OPLL had resulted in comparable postoperative outcomes at 2 years after surgery. |
| first_indexed | 2024-12-21T00:41:28Z |
| format | Article |
| id | doaj.art-b2eceb821d894b82b2923b5dc476f9fe |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-21T00:41:28Z |
| publishDate | 2022-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-b2eceb821d894b82b2923b5dc476f9fe2022-12-21T19:21:41ZengNature PortfolioScientific Reports2045-23222022-01-0112111310.1038/s41598-021-04727-1Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligamentHiroaki Nakashima0Shiro Imagama1Toshitaka Yoshii2Satoru Egawa3Kenichiro Sakai4Kazuo Kusano5Yukihiro Nakagawa6Takashi Hirai7Kanichiro Wada8Keiichi Katsumi9Kengo Fujii10Atsushi Kimura11Takeo Furuya12Tsukasa Kanchiku13Yukitaka Nagamoto14Yasushi Oshima15Narihito Nagoshi16Kei Ando17Masahiko Takahata18Kanji Mori19Hideaki Nakajima20Kazuma Murata21Shunji Matsunaga22Takashi Kaito23Kei Yamada24Sho Kobayashi25Satoshi Kato26Tetsuro Ohba27Satoshi Inami28Shunsuke Fujibayashi29Hiroyuki Katoh30Haruo Kanno31Yuanying Li32Hiroshi Yatsuya33Masao Koda34Yoshiharu Kawaguchi35Katsushi Takeshita36Morio Matsumoto37Masashi Yamazaki38Atsushi Okawa39Japanese Multicenter Research Organization for Ossification of the Spinal LigamentDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineDepartment of Orthopaedic Surgery, Tokyo Medical and Dental UniversityDepartment of Orthopaedic Surgery, Tokyo Medical and Dental UniversityDepartment of Orthopaedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopaedic Surgery, Kudanzaka HospitalDepartment of Orthopaedic Surgery, Wakayama Medical University Kihoku HospitalDepartment of Orthopaedic Surgery, Tokyo Medical and Dental UniversityDepartment of Orthopaedic Surgery, Hirosaki University Graduate School of MedicineDepartment of Orthopaedic Surgery, Niigata University Medicine and Dental General HospitalDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthoaedics, Jichi Medical UniversityDepartment of Orthopaedic Surgery, Chiba University Graduate School of MedicineDepartment of Orthopaedic Surgery, Yamaguchi University School of MedicineDepartment of Orthopaedic Surgery, Osaka Rosai HospitalDepartment of Orthopaedic Surgery, Faculty of Medicine, The University of TokyoDepartment of Orthopaedic Surgery, School of Medicine, Keio UniversityDepartment of Orthopaedic Surgery, Nagoya University Graduate School of MedicineDepartment of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityDepartment of Orthopaedic Surgery, Shiga University of Medical ScienceDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiDepartment of Orthopaedic Surgery, Tokyo Medical UniversityDepartment of Orthopaedic Surgery, Imakiire General HospitalDepartment of Orthopaedic Surgery, Graduate School of Medicine, Osaka UniversityDepartment of Orthopaedic Surgery, Kurume University School of MedicineDepartment of Orthopaedic Surgery, Hamamatsu University School of MedicineDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, University of YamanashiDepartment of Orthopaedic Surgery, Dokkyo Medical University School of MedicineDepartment of Orthopaedic Surgery, Graduate School of Medicine, Kyoto UniversityDepartment of Orthopaedic Surgery, Surgical Science, Tokai University School of MedicineDepartment of Orthopaedic Surgery, Tohoku University School of MedicineDepartment of Public Health, Fujita Health University School of MedicineDepartment of Public Health, Fujita Health University School of MedicineDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Faculty of Medicine, University of ToyamaDepartment of Orthoaedics, Jichi Medical UniversityDepartment of Orthopaedic Surgery, School of Medicine, Keio UniversityDepartment of Orthopaedic Surgery, Faculty of Medicine, University of TsukubaDepartment of Orthopaedic Surgery, Tokyo Medical and Dental UniversityAbstract This prospective multicenter study, established by the Japanese Ministry of Health, Labour and Welfare and involving 27 institutions, aimed to compare postoperative outcomes between laminoplasty (LM) and posterior fusion (PF) for cervical ossification of the posterior longitudinal ligament (OPLL), in order to address the controversy surrounding the role of instrumented fusion in cases of posterior surgical decompression for OPLL. 478 patients were considered for participation in the study; from among them, 189 (137 and 52 patients with LM and PF, respectively) were included and evaluated using the Japanese Orthopaedic Association (JOA) scores, the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and radiographical measurements. Basic demographic and radiographical data were reviewed, and the propensity to choose a surgical procedure was calculated. Preoperatively, there were no significant differences among the participants in terms of patient backgrounds, radiographical measurements (K-line or cervical alignment on X-ray, OPLL occupation ratio on computed tomography, increased signal intensity change on magnetic resonance imaging), or clinical status (JOA score and JOACMEQ) after adjustments. The overall risk of perioperative complications was found to be lower with LM (odds ratio [OR] 0.40, p = 0.006), and the rate of C5 palsy occurrence was significantly lower with LM (OR 0.11, p = 0.0002) than with PF. The range of motion (20.91° ± 1.05° and 9.38° ± 1.24°, p < 0.0001) in patients who had PF was significantly smaller than in those who had LM. However, multivariable logistic regression analysis showed no significant difference among the participants in JOA score, JOA recovery rate, or JOACMEQ improvement at two years. In contrast, OPLL progression was greater in the LM group than in the PF group (OR 2.73, p = 0.0002). Both LM and PF for cervical myelopathy due to OPLL had resulted in comparable postoperative outcomes at 2 years after surgery.https://doi.org/10.1038/s41598-021-04727-1 |
| spellingShingle | Hiroaki Nakashima Shiro Imagama Toshitaka Yoshii Satoru Egawa Kenichiro Sakai Kazuo Kusano Yukihiro Nakagawa Takashi Hirai Kanichiro Wada Keiichi Katsumi Kengo Fujii Atsushi Kimura Takeo Furuya Tsukasa Kanchiku Yukitaka Nagamoto Yasushi Oshima Narihito Nagoshi Kei Ando Masahiko Takahata Kanji Mori Hideaki Nakajima Kazuma Murata Shunji Matsunaga Takashi Kaito Kei Yamada Sho Kobayashi Satoshi Kato Tetsuro Ohba Satoshi Inami Shunsuke Fujibayashi Hiroyuki Katoh Haruo Kanno Yuanying Li Hiroshi Yatsuya Masao Koda Yoshiharu Kawaguchi Katsushi Takeshita Morio Matsumoto Masashi Yamazaki Atsushi Okawa Japanese Multicenter Research Organization for Ossification of the Spinal Ligament Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament Scientific Reports |
| title | Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament |
| title_full | Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament |
| title_fullStr | Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament |
| title_full_unstemmed | Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament |
| title_short | Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament |
| title_sort | comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament |
| url | https://doi.org/10.1038/s41598-021-04727-1 |
| work_keys_str_mv | AT hiroakinakashima comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT shiroimagama comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT toshitakayoshii comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT satoruegawa comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT kenichirosakai comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT kazuokusano comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT yukihironakagawa comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT takashihirai comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT kanichirowada comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT keiichikatsumi comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT kengofujii comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT atsushikimura comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT takeofuruya comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT tsukasakanchiku comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT yukitakanagamoto comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT yasushioshima comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT narihitonagoshi comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT keiando comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT masahikotakahata comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT kanjimori comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT hideakinakajima comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT kazumamurata comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT shunjimatsunaga comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT takashikaito comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT keiyamada comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT shokobayashi comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT satoshikato comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT tetsuroohba comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT satoshiinami comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT shunsukefujibayashi comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT hiroyukikatoh comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT haruokanno comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT yuanyingli comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT hiroshiyatsuya comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT masaokoda comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT yoshiharukawaguchi comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT katsushitakeshita comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT moriomatsumoto comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT masashiyamazaki comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT atsushiokawa comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament AT japanesemulticenterresearchorganizationforossificationofthespinalligament comparisonoflaminoplastyandposteriorfusionsurgeryforcervicalossificationofposteriorlongitudinalligament |