Comparison of outcomes of surgical treatment for ossification of the posterior longitudinal ligament versus other forms of degenerative cervical myelopathy results from the prospective, multicenter AOSpine CSM-international study of 479 patients

Hiroaki Nakashima, Lindsay Tetreault, Narihito Nagoshi, Aria Nouri, Paul Arnold, Yasutsugu Yukawa, Tomoaki Toyone, Masato Tanaka, Qiang Zhou, Michael G. Fehlings

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Degenerative cervical myelopathy (DCM) is an all-encompassing term that includes cervical spondylotic myelopathy (CSM), ossification of the posterior longitudinal ligament (OPLL), and other spinal abnormalities that cause cervical cord compression. It is unclear whether surgery is equally effective and safe for patients with OPLL as it is for those with other forms of DCM. The purpose of this study was to compare surgical outcomes of patients with OPLL and those with other forms of DCM. Methods: Four hundred and seventy-nine patients with symptomatic DCM were prospectively enrolled in the CSMInternational study at sixteen sites. Patients' functional status was evaluated using the modified Japanese Orthopaedic Association scale (mJOA) and the Nurick score. Quality of life was assessed using patient-reported outcome measures, including the Neck Disability Index (NDI) and the Short Form (SF)-36. Postoperative functional and quality-of-life outcomes were assessed at two years of follow-up, and scores were compared between patients with and without OPLL. Results: Of 479 patients, 135 (28.2%) had radiographic evidence of OPLL, and 344 (71.8%) had other forms of DCM. The two groups did not differ significantly in demographics, surgical approach, or baseline myelopathy severity. Patients with OPLL achieved similar functional outcomes by two years following surgery compared with patients with other forms of DCM. With respect to quality of life, the NDI and most of the subscales of the SF-36 were not different between the two diagnostic groups. There was a higher risk of perioperative complications in the OPLL group (p = 0.054), although this relationship did not reach statistical significance. Rates of neurological complications did not differ significantly between diagnostic groups. Conclusions: Surgical decompression for the treatment of OPLL resulted in improvements in functional status and quality of life comparable to those seen in patients with other forms of DCM. Patients with OPLL were at a higher risk of perioperative complications than patients with other forms of DCM. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)370-378
Number of pages9
JournalJournal of Bone and Joint Surgery - American Volume
Volume98
Issue number5
DOIs
Publication statusPublished - 2016 Mar 2

Fingerprint

Ossification of Posterior Longitudinal Ligament
Spinal Cord Diseases
Quality of Life
Neck
Surgical Decompression

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Orthopedics and Sports Medicine

Cite this

Comparison of outcomes of surgical treatment for ossification of the posterior longitudinal ligament versus other forms of degenerative cervical myelopathy results from the prospective, multicenter AOSpine CSM-international study of 479 patients. / Nakashima, Hiroaki; Tetreault, Lindsay; Nagoshi, Narihito; Nouri, Aria; Arnold, Paul; Yukawa, Yasutsugu; Toyone, Tomoaki; Tanaka, Masato; Zhou, Qiang; Fehlings, Michael G.

In: Journal of Bone and Joint Surgery - American Volume, Vol. 98, No. 5, 02.03.2016, p. 370-378.

Research output: Contribution to journalArticle

@article{1b3a289e37de481fb87dd529c9a8ee38,
title = "Comparison of outcomes of surgical treatment for ossification of the posterior longitudinal ligament versus other forms of degenerative cervical myelopathy results from the prospective, multicenter AOSpine CSM-international study of 479 patients",
abstract = "Background: Degenerative cervical myelopathy (DCM) is an all-encompassing term that includes cervical spondylotic myelopathy (CSM), ossification of the posterior longitudinal ligament (OPLL), and other spinal abnormalities that cause cervical cord compression. It is unclear whether surgery is equally effective and safe for patients with OPLL as it is for those with other forms of DCM. The purpose of this study was to compare surgical outcomes of patients with OPLL and those with other forms of DCM. Methods: Four hundred and seventy-nine patients with symptomatic DCM were prospectively enrolled in the CSMInternational study at sixteen sites. Patients' functional status was evaluated using the modified Japanese Orthopaedic Association scale (mJOA) and the Nurick score. Quality of life was assessed using patient-reported outcome measures, including the Neck Disability Index (NDI) and the Short Form (SF)-36. Postoperative functional and quality-of-life outcomes were assessed at two years of follow-up, and scores were compared between patients with and without OPLL. Results: Of 479 patients, 135 (28.2{\%}) had radiographic evidence of OPLL, and 344 (71.8{\%}) had other forms of DCM. The two groups did not differ significantly in demographics, surgical approach, or baseline myelopathy severity. Patients with OPLL achieved similar functional outcomes by two years following surgery compared with patients with other forms of DCM. With respect to quality of life, the NDI and most of the subscales of the SF-36 were not different between the two diagnostic groups. There was a higher risk of perioperative complications in the OPLL group (p = 0.054), although this relationship did not reach statistical significance. Rates of neurological complications did not differ significantly between diagnostic groups. Conclusions: Surgical decompression for the treatment of OPLL resulted in improvements in functional status and quality of life comparable to those seen in patients with other forms of DCM. Patients with OPLL were at a higher risk of perioperative complications than patients with other forms of DCM. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.",
author = "Hiroaki Nakashima and Lindsay Tetreault and Narihito Nagoshi and Aria Nouri and Paul Arnold and Yasutsugu Yukawa and Tomoaki Toyone and Masato Tanaka and Qiang Zhou and Fehlings, {Michael G.}",
year = "2016",
month = "3",
day = "2",
doi = "10.2106/JBJS.O.00397",
language = "English",
volume = "98",
pages = "370--378",
journal = "Journal of Bone and Joint Surgery - Series A",
issn = "0021-9355",
publisher = "Journal of Bone and Joint Surgery Inc.",
number = "5",

}

TY - JOUR

T1 - Comparison of outcomes of surgical treatment for ossification of the posterior longitudinal ligament versus other forms of degenerative cervical myelopathy results from the prospective, multicenter AOSpine CSM-international study of 479 patients

AU - Nakashima, Hiroaki

AU - Tetreault, Lindsay

AU - Nagoshi, Narihito

AU - Nouri, Aria

AU - Arnold, Paul

AU - Yukawa, Yasutsugu

AU - Toyone, Tomoaki

AU - Tanaka, Masato

AU - Zhou, Qiang

AU - Fehlings, Michael G.

PY - 2016/3/2

Y1 - 2016/3/2

N2 - Background: Degenerative cervical myelopathy (DCM) is an all-encompassing term that includes cervical spondylotic myelopathy (CSM), ossification of the posterior longitudinal ligament (OPLL), and other spinal abnormalities that cause cervical cord compression. It is unclear whether surgery is equally effective and safe for patients with OPLL as it is for those with other forms of DCM. The purpose of this study was to compare surgical outcomes of patients with OPLL and those with other forms of DCM. Methods: Four hundred and seventy-nine patients with symptomatic DCM were prospectively enrolled in the CSMInternational study at sixteen sites. Patients' functional status was evaluated using the modified Japanese Orthopaedic Association scale (mJOA) and the Nurick score. Quality of life was assessed using patient-reported outcome measures, including the Neck Disability Index (NDI) and the Short Form (SF)-36. Postoperative functional and quality-of-life outcomes were assessed at two years of follow-up, and scores were compared between patients with and without OPLL. Results: Of 479 patients, 135 (28.2%) had radiographic evidence of OPLL, and 344 (71.8%) had other forms of DCM. The two groups did not differ significantly in demographics, surgical approach, or baseline myelopathy severity. Patients with OPLL achieved similar functional outcomes by two years following surgery compared with patients with other forms of DCM. With respect to quality of life, the NDI and most of the subscales of the SF-36 were not different between the two diagnostic groups. There was a higher risk of perioperative complications in the OPLL group (p = 0.054), although this relationship did not reach statistical significance. Rates of neurological complications did not differ significantly between diagnostic groups. Conclusions: Surgical decompression for the treatment of OPLL resulted in improvements in functional status and quality of life comparable to those seen in patients with other forms of DCM. Patients with OPLL were at a higher risk of perioperative complications than patients with other forms of DCM. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

AB - Background: Degenerative cervical myelopathy (DCM) is an all-encompassing term that includes cervical spondylotic myelopathy (CSM), ossification of the posterior longitudinal ligament (OPLL), and other spinal abnormalities that cause cervical cord compression. It is unclear whether surgery is equally effective and safe for patients with OPLL as it is for those with other forms of DCM. The purpose of this study was to compare surgical outcomes of patients with OPLL and those with other forms of DCM. Methods: Four hundred and seventy-nine patients with symptomatic DCM were prospectively enrolled in the CSMInternational study at sixteen sites. Patients' functional status was evaluated using the modified Japanese Orthopaedic Association scale (mJOA) and the Nurick score. Quality of life was assessed using patient-reported outcome measures, including the Neck Disability Index (NDI) and the Short Form (SF)-36. Postoperative functional and quality-of-life outcomes were assessed at two years of follow-up, and scores were compared between patients with and without OPLL. Results: Of 479 patients, 135 (28.2%) had radiographic evidence of OPLL, and 344 (71.8%) had other forms of DCM. The two groups did not differ significantly in demographics, surgical approach, or baseline myelopathy severity. Patients with OPLL achieved similar functional outcomes by two years following surgery compared with patients with other forms of DCM. With respect to quality of life, the NDI and most of the subscales of the SF-36 were not different between the two diagnostic groups. There was a higher risk of perioperative complications in the OPLL group (p = 0.054), although this relationship did not reach statistical significance. Rates of neurological complications did not differ significantly between diagnostic groups. Conclusions: Surgical decompression for the treatment of OPLL resulted in improvements in functional status and quality of life comparable to those seen in patients with other forms of DCM. Patients with OPLL were at a higher risk of perioperative complications than patients with other forms of DCM. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

UR - http://www.scopus.com/inward/record.url?scp=84977763316&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84977763316&partnerID=8YFLogxK

U2 - 10.2106/JBJS.O.00397

DO - 10.2106/JBJS.O.00397

M3 - Article

VL - 98

SP - 370

EP - 378

JO - Journal of Bone and Joint Surgery - Series A

JF - Journal of Bone and Joint Surgery - Series A

SN - 0021-9355

IS - 5

ER -