PMID- 37368973
OWN - NLM
STAT- MEDLINE
DCOM- 20230828
LR  - 20230828
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 48
IP  - 18
DP  - 2023 Sep 15
TI  - Preoperative Symptom Duration Influences Neurological Recovery and 
      Patient-Reported Outcome Measures After Surgical Treatment of Cervical 
      Ossification of the Posterior Longitudinal Ligament.
PG  - 1259-1265
LID - 10.1097/BRS.0000000000004762 [doi]
AB  - STUDY DESIGN: A prospective multicenter study. OBJECTIVE: To investigate the 
      effect of preoperative symptom duration on neurological recovery for the 
      treatment of cervical ossification of the posterior longitudinal ligament (OPLL). 
      SUMMARY OF BACKGROUND DATA: The optimal timing to perform surgery in the setting 
      of cervical OPLL remains unknown. It is important to know the influence of 
      symptom duration on postoperative outcomes to facilitate discussions regarding 
      the timing of surgery. PATIENTS AND METHODS: The study included 395 patients (291 
      men and 104 women; mean age, 63.7 +/- 11.4 yr): 204 were treated with laminoplasty, 
      90 with posterior decompression and fusion, 85 with anterior decompression and 
      fusion, and 16 with other procedures. The Japanese Orthopedic Association (JOA) 
      score and patient-reported outcomes of the JOA Cervical Myelopathy Evaluation 
      Questionnaire were used to assess clinical outcomes preoperatively and 2 years 
      after surgery. Logistic regression analysis was used to identify factors 
      associated with the achievement of minimum clinically important difference (MCID) 
      after surgery. RESULTS: The recovery rate was significantly lower in the group 
      with symptom duration of >/=5 years compared with the groups with durations of <0.5 
      years, 0.5 to 1 year, and 1 to 2 years. Improvement of JOA Cervical Myelopathy 
      Evaluation Questionnaire in the upper extremity function score ( P < 0.001), 
      lower extremity function ( P = 0.039), quality of life ( P = 0.053), and bladder 
      function ( P = 0.034) were all decreased when the symptom duration exceeded 2 
      years. Duration of symptoms ( P = 0.001), age ( P < 0.001), and body mass index ( 
      P < 0.001) were significantly associated with the achievement of MCID. The cutoff 
      value we established for symptom duration was 23 months (area under the curve, 
      0.616; sensitivity, 67.4%; specificity, 53.5%). CONCLUSIONS: Symptom duration had 
      a significant impact on neurological recovery and patient-reported outcome 
      measures in this series of patients undergoing surgery for cervical OPLL. 
      Patients with symptom duration exceeding 23 months may be at greater risk of 
      failing to achieve MCID after surgery. LEVEL OF EVIDENCE: 3.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Matsukura, Yu
AU  - Matsukura Y
AD  - Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, 
      Japan.
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
FAU - Egawa, Satoru
AU  - Egawa S
AD  - Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, 
      Japan.
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
FAU - Inose, Hiroyuki
AU  - Inose H
AD  - Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, 
      Japan.
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
FAU - Sakai, Kenichiro
AU  - Sakai K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital 
      Kawaguchishi, Saitama, Japan.
FAU - Kusano, Kazuo
AU  - Kusano K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Kudanzaka Hospital, Chiyadaku, Japan.
FAU - Tsutsui, Shunji
AU  - Tsutsui S
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan.
FAU - Hirai, Takashi
AU  - Hirai T
AD  - Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, 
      Japan.
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
FAU - Wada, Kanichiro
AU  - Wada K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Hirosaki University Graduate School of 
      Medicine, Hirosaki, Aomori, Japan.
FAU - Katsumi, Keiichi
AU  - Katsumi K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Niigata University Medical and Dental General 
      Hospital, Niigata, Niigata, Japan.
FAU - Koda, Masao
AU  - Koda M
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 
      Tsukuba, Ibaraki, Japan.
FAU - Kimura, Atsushi
AU  - Kimura A
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan.
FAU - Furuya, Takeo
AU  - Furuya T
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 
      Chiba, Chiba, Japan.
FAU - Maki, Satoshi
AU  - Maki S
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 
      Chiba, Chiba, Japan.
FAU - Nagoshi, Narihito
AU  - Nagoshi N
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
FAU - Nishida, Norihiro
AU  - Nishida N
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Yamaguchi University Graduate School of 
      Medicine, Ube City, Yamaguchi Prefecture, Japan.
FAU - Nagamoto, Yukitaka
AU  - Nagamoto Y
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Osaka Rosai Hospital, Sakaishi, Osaka, Japan.
FAU - Oshima, Yasushi
AU  - Oshima Y
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, The University of Tokyo, Bunkyo-ku, Tokyo, 
      Japan.
FAU - Ando, Kei
AU  - Ando K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Aichi, Japan.
FAU - Nakashima, Hiroaki
AU  - Nakashima H
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Aichi, Japan.
FAU - Takahata, Masahiko
AU  - Takahata M
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Hokkaido University, Sapporo, Japan.
FAU - Mori, Kanji
AU  - Mori K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Shiga University of Medical Science, 
      Tsukinowa-cho, Seta, Otsu, Shiga, Japan.
FAU - Nakajima, Hideaki
AU  - Nakajima H
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedics and Rehabilitation Medicine, University of Fukui, 
      Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, Japan.
FAU - Murata, Kazuma
AU  - Murata K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, 
      Japan.
FAU - Miyagi, Masayuki
AU  - Miyagi M
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Kitazato Universiy Hospital, Minami-ku, 
      Sagamiharashi, Kanagawa, Japan.
FAU - Kaito, Takashi
AU  - Kaito T
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, 
      Suita-shi, Osaka, Japan.
FAU - Yamada, Kei
AU  - Yamada K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Kurume University School of Medicine, 
      Kurume-shi, Fukuoka, Japan.
FAU - Banno, Tomohiro
AU  - Banno T
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 
      Hamamatsu, Shizuoka, Japan.
FAU - Kato, Satoshi
AU  - Kato S
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa 
      University, Kanazawa, Japan.
FAU - Ohba, Tetsuro
AU  - Ohba T
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, University of Yamanashi, Yamanashi, Japan.
FAU - Moridaira, Hiroshi
AU  - Moridaira H
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, 
      Tochigi, Japan.
FAU - Fujibayashi, Shunsuke
AU  - Fujibayashi S
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, 
      Shogoin, Sakyo-ku, Kyoto, Japan.
FAU - Katoh, Hiroyuki
AU  - Katoh H
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Surgical Science, Tokai University School of 
      Medicine, Isehara, Kanagawa, Japan.
FAU - Kanno, Haruo
AU  - Kanno H
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Tohoku University School of Medicine, Sendai, 
      Miyagi, Japan.
FAU - Taneichi, Hiroshi
AU  - Taneichi H
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Dokkyo Medical University School of Medicine, 
      Tochigi, Japan.
FAU - Imagama, Shiro
AU  - Imagama S
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Aichi, Japan.
FAU - Kawaguchi, Yoshiharu
AU  - Kawaguchi Y
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama, Japan.
FAU - Takeshita, Katsushi
AU  - Takeshita K
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedics, Jichi Medical University, Shimotsuke, Tochigi, Japan.
FAU - Nakamura, Masaya
AU  - Nakamura M
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
FAU - Matsumoto, Morio
AU  - Matsumoto M
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, 
      Japan.
FAU - Yamazaki, Masashi
AU  - Yamazaki M
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
AD  - Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 
      Tsukuba, Ibaraki, Japan.
FAU - Okawa, Atsushi
AU  - Okawa A
AD  - Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, 
      Japan.
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
FAU - Yoshii, Toshitaka
AU  - Yoshii T
AD  - Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, 
      Japan.
AD  - Japanese Multicenter Research Organization for Ossification of the Spinal 
      Ligament.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230627
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Male
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - Aged
MH  - Longitudinal Ligaments/surgery
MH  - Treatment Outcome
MH  - Prospective Studies
MH  - Quality of Life
MH  - Osteogenesis
MH  - Cervical Vertebrae/surgery
MH  - *Ossification of Posterior Longitudinal Ligament/surgery/complications
MH  - *Laminoplasty/methods
MH  - Decompression, Surgical/methods
MH  - *Spinal Cord Diseases/surgery/complications
MH  - Patient Reported Outcome Measures
MH  - Retrospective Studies
COIS- The authors report no conflicts of interest.
EDAT- 2023/06/27 19:13
MHDA- 2023/08/28 06:42
CRDT- 2023/06/27 14:29
PHST- 2023/05/02 00:00 [received]
PHST- 2023/06/20 00:00 [accepted]
PHST- 2023/08/28 06:42 [medline]
PHST- 2023/06/27 19:13 [pubmed]
PHST- 2023/06/27 14:29 [entrez]
AID - 00007632-990000000-00400 [pii]
AID - 10.1097/BRS.0000000000004762 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2023 Sep 15;48(18):1259-1265. doi: 
      10.1097/BRS.0000000000004762. Epub 2023 Jun 27.