Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study

Narihito Nagoshi; Toshitaka Yoshii; Satoru Egawa; Kenichiro Sakai; Kazuo Kusano; Shunji Tsutsui; Takashi Hirai; Yu Matsukura; Kanichiro Wada; Keiichi Katsumi; Masao Koda; Atsushi Kimura; Takeo Furuya; Yasunori Sato; Satoshi Maki; 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; Hiroshi Moridaira; Shunsuke Fujibayashi; Hiroyuki Katoh; Haruo Kanno; Kota Watanabe; Hiroshi Taneichi; Shiro Imagama; Yoshiharu Kawaguchi; Katsushi Takeshita; Masaya Nakamura; Morio Matsumoto; Masashi Yamazaki

doi:10.1097/BRS.0000000000004634

Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study

Narihito Nagoshi^*, Toshitaka Yoshii, Satoru Egawa, Kenichiro Sakai, Kazuo Kusano, Shunji Tsutsui, Takashi Hirai, Yu Matsukura, Kanichiro Wada, Keiichi Katsumi, Masao Koda, Atsushi Kimura, Takeo Furuya, Yasunori Sato, Satoshi Maki, Norihiro Nishida, Yukitaka Nagamoto, Yasushi Oshima, Kei Ando, Hiroaki NakashimaMasahiko Takahata, Kanji Mori, Hideaki Nakajima, Kazuma Murata, Masayuki Miyagi, Takashi Kaito, Kei Yamada, Tomohiro Banno, Satoshi Kato, Tetsuro Ohba, Hiroshi Moridaira, Shunsuke Fujibayashi, Hiroyuki Katoh, Haruo Kanno, Kota Watanabe, Hiroshi Taneichi, Shiro Imagama, Yoshiharu Kawaguchi, Katsushi Takeshita, Masaya Nakamura, Morio Matsumoto, Masashi Yamazaki

^*Corresponding author for this work

Orthopaedic Surgery

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Study Design. A prospective multicenter study. Objective. The objective of this study is to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (-) cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data. Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (-) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined. Materials and Methods. A total of 478 patients with myelopathy due to cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for two years. Of the 478 patients, 45 and 46 with K-line (-) underwent anterior and posterior fusion surgeries, respectively. After adjusting for confounders in baseline characteristics using a propensity score-matched analysis, 54 patients in both the anterior and posterior groups (27 patients each) were evaluated. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. Results. Both approaches showed comparable neurological and functional recovery. The cervical range of motion was significantly restricted in the posterior group because of the large number of fused vertebrae compared with the anterior group. The incidence of surgical complications was comparable between the cohorts, but the posterior group demonstrated a higher frequency of segmental motor paralysis, whereas the anterior group more frequently reported postoperative dysphagia. Conclusions. Clinical improvement was comparable between anterior and posterior fusion surgeries for patients with K-line (-) OPLL. The ideal surgical approach should be informed based on the balance between the surgeon's technical preference and the risk of complications.

Original language	English
Pages (from-to)	937-943
Number of pages	7
Journal	Spine
Volume	48
Issue number	13
DOIs	https://doi.org/10.1097/BRS.0000000000004634
State	Published - 2023/07/01

Keywords

K-line
anterior and posterior surgery
cervical range of motion
cervical spine
dysphagia
ossification of the posterior longitudinal ligament
patient-reported outcome
segmental motor paralysis
surgical complications
surgical outcomes

ASJC Scopus subject areas

Orthopedics and Sports Medicine
Clinical Neurology

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10.1097/BRS.0000000000004634

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Nagoshi, N., Yoshii, T., Egawa, S., Sakai, K., Kusano, K., Tsutsui, S., Hirai, T., Matsukura, Y., Wada, K., Katsumi, K., Koda, M., Kimura, A., Furuya, T., Sato, Y., Maki, S., Nishida, N., Nagamoto, Y., Oshima, Y., Ando, K., ... Yamazaki, M. (2023). Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study. Spine, 48(13), 937-943. https://doi.org/10.1097/BRS.0000000000004634

@article{b76cada04e1d479a8cabed9c81208439,

title = "Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study",

abstract = "Study Design. A prospective multicenter study. Objective. The objective of this study is to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (-) cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data. Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (-) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined. Materials and Methods. A total of 478 patients with myelopathy due to cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for two years. Of the 478 patients, 45 and 46 with K-line (-) underwent anterior and posterior fusion surgeries, respectively. After adjusting for confounders in baseline characteristics using a propensity score-matched analysis, 54 patients in both the anterior and posterior groups (27 patients each) were evaluated. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. Results. Both approaches showed comparable neurological and functional recovery. The cervical range of motion was significantly restricted in the posterior group because of the large number of fused vertebrae compared with the anterior group. The incidence of surgical complications was comparable between the cohorts, but the posterior group demonstrated a higher frequency of segmental motor paralysis, whereas the anterior group more frequently reported postoperative dysphagia. Conclusions. Clinical improvement was comparable between anterior and posterior fusion surgeries for patients with K-line (-) OPLL. The ideal surgical approach should be informed based on the balance between the surgeon's technical preference and the risk of complications.",

keywords = "K-line, anterior and posterior surgery, cervical range of motion, cervical spine, dysphagia, ossification of the posterior longitudinal ligament, patient-reported outcome, segmental motor paralysis, surgical complications, surgical outcomes",

author = "Narihito Nagoshi and Toshitaka Yoshii and Satoru Egawa and Kenichiro Sakai and Kazuo Kusano and Shunji Tsutsui and Takashi Hirai and Yu Matsukura and Kanichiro Wada and Keiichi Katsumi and Masao Koda and Atsushi Kimura and Takeo Furuya and Yasunori Sato and Satoshi Maki and Norihiro Nishida and Yukitaka Nagamoto and Yasushi Oshima and Kei Ando and Hiroaki Nakashima and Masahiko Takahata and Kanji Mori and Hideaki Nakajima and Kazuma Murata and Masayuki Miyagi and Takashi Kaito and Kei Yamada and Tomohiro Banno and Satoshi Kato and Tetsuro Ohba and Hiroshi Moridaira and Shunsuke Fujibayashi and Hiroyuki Katoh and Haruo Kanno and Kota Watanabe and Hiroshi Taneichi and Shiro Imagama and Yoshiharu Kawaguchi and Katsushi Takeshita and Masaya Nakamura and Morio Matsumoto and Masashi Yamazaki",

year = "2023",

month = jul,

day = "1",

doi = "10.1097/BRS.0000000000004634",

language = "英語",

volume = "48",

pages = "937--943",

journal = "Spine",

issn = "0362-2436",

publisher = "Wolters Kluwer Health",

number = "13",

}

Nagoshi, N, Yoshii, T, Egawa, S, Sakai, K, Kusano, K, Tsutsui, S, Hirai, T, Matsukura, Y, Wada, K, Katsumi, K, Koda, M, Kimura, A, Furuya, T, Sato, Y, Maki, S, Nishida, N, Nagamoto, Y, Oshima, Y, Ando, K, Nakashima, H, Takahata, M, Mori, K, Nakajima, H, Murata, K, Miyagi, M, Kaito, T, Yamada, K, Banno, T, Kato, S, Ohba, T, Moridaira, H, Fujibayashi, S, Katoh, H, Kanno, H, Watanabe, K, Taneichi, H, Imagama, S, Kawaguchi, Y, Takeshita, K, Nakamura, M, Matsumoto, M & Yamazaki, M 2023, 'Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study', Spine, vol. 48, no. 13, pp. 937-943. https://doi.org/10.1097/BRS.0000000000004634

TY - JOUR

T1 - Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament

T2 - A Prospective Multicenter Study

AU - Nagoshi, Narihito

AU - Yoshii, Toshitaka

AU - Egawa, Satoru

AU - Sakai, Kenichiro

AU - Kusano, Kazuo

AU - Tsutsui, Shunji

AU - Hirai, Takashi

AU - Matsukura, Yu

AU - Wada, Kanichiro

AU - Katsumi, Keiichi

AU - Koda, Masao

AU - Kimura, Atsushi

AU - Furuya, Takeo

AU - Sato, Yasunori

AU - Maki, Satoshi

AU - Nishida, Norihiro

AU - Nagamoto, Yukitaka

AU - Oshima, Yasushi

AU - Ando, Kei

AU - Nakashima, Hiroaki

AU - Takahata, Masahiko

AU - Mori, Kanji

AU - Nakajima, Hideaki

AU - Murata, Kazuma

AU - Miyagi, Masayuki

AU - Kaito, Takashi

AU - Yamada, Kei

AU - Banno, Tomohiro

AU - Kato, Satoshi

AU - Ohba, Tetsuro

AU - Moridaira, Hiroshi

AU - Fujibayashi, Shunsuke

AU - Katoh, Hiroyuki

AU - Kanno, Haruo

AU - Watanabe, Kota

AU - Taneichi, Hiroshi

AU - Imagama, Shiro

AU - Kawaguchi, Yoshiharu

AU - Takeshita, Katsushi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Yamazaki, Masashi

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Study Design. A prospective multicenter study. Objective. The objective of this study is to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (-) cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data. Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (-) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined. Materials and Methods. A total of 478 patients with myelopathy due to cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for two years. Of the 478 patients, 45 and 46 with K-line (-) underwent anterior and posterior fusion surgeries, respectively. After adjusting for confounders in baseline characteristics using a propensity score-matched analysis, 54 patients in both the anterior and posterior groups (27 patients each) were evaluated. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. Results. Both approaches showed comparable neurological and functional recovery. The cervical range of motion was significantly restricted in the posterior group because of the large number of fused vertebrae compared with the anterior group. The incidence of surgical complications was comparable between the cohorts, but the posterior group demonstrated a higher frequency of segmental motor paralysis, whereas the anterior group more frequently reported postoperative dysphagia. Conclusions. Clinical improvement was comparable between anterior and posterior fusion surgeries for patients with K-line (-) OPLL. The ideal surgical approach should be informed based on the balance between the surgeon's technical preference and the risk of complications.

AB - Study Design. A prospective multicenter study. Objective. The objective of this study is to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (-) cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data. Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (-) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined. Materials and Methods. A total of 478 patients with myelopathy due to cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for two years. Of the 478 patients, 45 and 46 with K-line (-) underwent anterior and posterior fusion surgeries, respectively. After adjusting for confounders in baseline characteristics using a propensity score-matched analysis, 54 patients in both the anterior and posterior groups (27 patients each) were evaluated. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. Results. Both approaches showed comparable neurological and functional recovery. The cervical range of motion was significantly restricted in the posterior group because of the large number of fused vertebrae compared with the anterior group. The incidence of surgical complications was comparable between the cohorts, but the posterior group demonstrated a higher frequency of segmental motor paralysis, whereas the anterior group more frequently reported postoperative dysphagia. Conclusions. Clinical improvement was comparable between anterior and posterior fusion surgeries for patients with K-line (-) OPLL. The ideal surgical approach should be informed based on the balance between the surgeon's technical preference and the risk of complications.

KW - K-line

KW - anterior and posterior surgery

KW - cervical range of motion

KW - cervical spine

KW - dysphagia

KW - ossification of the posterior longitudinal ligament

KW - patient-reported outcome

KW - segmental motor paralysis

KW - surgical complications

KW - surgical outcomes

UR - http://www.scopus.com/inward/record.url?scp=85162913703&partnerID=8YFLogxK

U2 - 10.1097/BRS.0000000000004634

DO - 10.1097/BRS.0000000000004634

M3 - 学術論文

C2 - 36940262

AN - SCOPUS:85162913703

SN - 0362-2436

VL - 48

SP - 937

EP - 943

JO - Spine

JF - Spine

IS - 13

ER -

Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study

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Keywords

ASJC Scopus subject areas

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