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

doi:10.3390/jcm11237012

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 NakashimaMasahiko 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

^*Corresponding author for this work

Orthopaedic Surgery

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

8 Scopus citations

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.

Original language	English
Article number	7012
Journal	Journal of Clinical Medicine
Volume	11
Issue number	23
DOIs	https://doi.org/10.3390/jcm11237012
State	Published - 2022/12

Keywords

anterior decompression and fusion
laminoplasty
minimum clinically important difference
neurological recovery
ossification of the posterior longitudinal ligament
propensity score matching

ASJC Scopus subject areas

General Medicine

Access to Document

10.3390/jcm11237012

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Yoshii, T., Morishita, S., Egawa, S., Sakai, K., Kusano, K., Tsutsui, S., Hirai, T., Matsukura, Y., Wada, K., Katsumi, K., Koda, M., Kimura, A., Furuya, T., Maki, S., Nagoshi, N., Nishida, N., Nagamoto, Y., Oshima, Y., Ando, K., ... Okawa, A. (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. Journal of Clinical Medicine, 11(23), Article 7012. https://doi.org/10.3390/jcm11237012

@article{13a27716d44146cda93b4aa0e6a5aaef,

title = "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",

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 = "anterior decompression and fusion, laminoplasty, minimum clinically important difference, neurological recovery, ossification of the posterior longitudinal ligament, propensity score matching",

author = "Toshitaka Yoshii and Shingo Morishita 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 Satoshi Maki and Narihito Nagoshi 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 Satoshi Inami and Shunsuke Fujibayashi and Hiroyuki Katoh and Haruo Kanno and Hiroshi Taneichi and Shiro Imagama and Yoshiharu Kawaguchi and Katsushi Takeshita and Morio Matsumoto and Masashi Yamazaki and Atsushi Okawa",

note = "Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = dec,

doi = "10.3390/jcm11237012",

language = "英語",

volume = "11",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "23",

}

Yoshii, T, Morishita, S, Egawa, S, Sakai, K, Kusano, K, Tsutsui, S, Hirai, T, Matsukura, Y, Wada, K, Katsumi, K, Koda, M, Kimura, A, Furuya, T, Maki, S, Nagoshi, N, 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, Inami, S, Fujibayashi, S, Katoh, H, Kanno, H, Taneichi, H, Imagama, S, Kawaguchi, Y, Takeshita, K, Matsumoto, M, Yamazaki, M & Okawa, A 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', Journal of Clinical Medicine, vol. 11, no. 23, 7012. https://doi.org/10.3390/jcm11237012

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. / Yoshii, Toshitaka; Morishita, Shingo; Egawa, Satoru et al.
In: Journal of Clinical Medicine, Vol. 11, No. 23, 7012, 12.2022.

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

TY - JOUR

T1 - Prospective Investigation of Surgical Outcomes after Anterior Decompression with Fusion and Laminoplasty for the Cervical Ossification of the Posterior Longitudinal Ligament

T2 - A Propensity Score Matching Analysis

AU - Yoshii, Toshitaka

AU - Morishita, Shingo

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 - Maki, Satoshi

AU - Nagoshi, Narihito

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 - Inami, Satoshi

AU - Fujibayashi, Shunsuke

AU - Katoh, Hiroyuki

AU - Kanno, Haruo

AU - Taneichi, Hiroshi

AU - Imagama, Shiro

AU - Kawaguchi, Yoshiharu

AU - Takeshita, Katsushi

AU - Matsumoto, Morio

AU - Yamazaki, Masashi

AU - Okawa, Atsushi

PY - 2022/12

Y1 - 2022/12

N2 - 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.

AB - 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.

KW - anterior decompression and fusion

KW - laminoplasty

KW - minimum clinically important difference

KW - neurological recovery

KW - ossification of the posterior longitudinal ligament

KW - propensity score matching

UR - http://www.scopus.com/inward/record.url?scp=85143627730&partnerID=8YFLogxK

U2 - 10.3390/jcm11237012

DO - 10.3390/jcm11237012

M3 - 学術論文

C2 - 36498586

AN - SCOPUS:85143627730

SN - 2077-0383

VL - 11

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 23

M1 - 7012

ER -