TY - JOUR
T1 - Perioperative Complications in Posterior Surgeries for Cervical Ossification of the Posterior Longitudinal Ligament
T2 - A Prospective Nationwide Investigation
AU - Yoshii, Toshitaka
AU - Egawa, Satoru
AU - Sakai, Kenichiro
AU - Kusano, Kazuo
AU - Nakagawa, Yukihiro
AU - Hirai, Takashi
AU - Wada, Kanichiro
AU - Katsumi, Keiichi
AU - Fujii, Kengo
AU - Kimura, Atsushi
AU - Furuya, Takeo
AU - Nagoshi, Narihito
AU - Kanchiku, Tsukasa
AU - Nagamoto, Yukitaka
AU - Oshima, Yasushi
AU - Ando, Kei
AU - Takahata, Masahiko
AU - Mori, Kanji
AU - Nakajima, Hideaki
AU - Murata, Kazuma
AU - Matsunaga, Shunji
AU - Kaito, Takashi
AU - Yamada, Kei
AU - Kobayashi, Sho
AU - Kato, Satoshi
AU - Ohba, Tetsuro
AU - Inami, Satoshi
AU - Fujibayashi, Shunsuke
AU - Katoh, Hiroyuki
AU - Kanno, Haruo
AU - Imagama, Shiro
AU - Koda, Masao
AU - Kawaguchi, Yoshiharu
AU - Takeshita, Katsushi
AU - Matsumoto, Morio
AU - Yamazaki, Masashi
AU - Okawa, Atsushi
N1 - Publisher Copyright:
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - STUDY DESIGN: This was a prospective multicenter study. OBJECTIVE: The aim of this study was to investigate the perioperative complications of posterior surgeries for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: Surgical treatment for cervical OPLL has a high risk of various complications. Laminoplasty (LAMP) and posterior decompression and instrumented fusion (PDF) are effective for multilevel cervical OPLL; however, few studies have focused on the surgical complications of these 2 procedures. MATERIALS AND METHODS: We prospectively included 380 patients undergoing posterior surgeries for cervical OPLL (LAMP: 270 patients, PDF: 110 patients), and investigated the systemic and local complications, including neurological complications. We further evaluated risk factors related to the neurological complications. RESULTS: Motor palsy was found in 40 patients (10.5%), and motor palsy in the upper extremity was most frequent (8.9%), especially in patients who received PDF (14.5%). Motor palsies involving the lower extremities was found in 6 patients (1.6%). Regarding local complications, dural tears (3.9%) and surgical site infections (2.6%) were common. In the univariate analysis, body mass index, preoperative cervical alignment, fusion surgery, and the number of operated segments were the factors related to motor palsy. Multivariate analysis revealed that fusion surgery and a small preoperative C2-C7 angle were the independent factors related to motor palsy. Motor palsy involving the lower extremities tended to be found at early time points after the surgery, and all the patients fully recovered. Motor palsy in the upper extremities occurred in a delayed manner, and 68.8% of patients with PDF showed good recovery, whereas 81.3% of patients with LAMP showed good recovery. CONCLUSIONS: In posterior surgeries for cervical OPLL, segmental motor palsy in the upper extremity was most frequently observed, especially in patients who received PDF. Fusion and a small preoperative C2-C7 angle were the independent risk factors for motor palsy. LEVEL OF EVIDENCE: Level III.
AB - STUDY DESIGN: This was a prospective multicenter study. OBJECTIVE: The aim of this study was to investigate the perioperative complications of posterior surgeries for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: Surgical treatment for cervical OPLL has a high risk of various complications. Laminoplasty (LAMP) and posterior decompression and instrumented fusion (PDF) are effective for multilevel cervical OPLL; however, few studies have focused on the surgical complications of these 2 procedures. MATERIALS AND METHODS: We prospectively included 380 patients undergoing posterior surgeries for cervical OPLL (LAMP: 270 patients, PDF: 110 patients), and investigated the systemic and local complications, including neurological complications. We further evaluated risk factors related to the neurological complications. RESULTS: Motor palsy was found in 40 patients (10.5%), and motor palsy in the upper extremity was most frequent (8.9%), especially in patients who received PDF (14.5%). Motor palsies involving the lower extremities was found in 6 patients (1.6%). Regarding local complications, dural tears (3.9%) and surgical site infections (2.6%) were common. In the univariate analysis, body mass index, preoperative cervical alignment, fusion surgery, and the number of operated segments were the factors related to motor palsy. Multivariate analysis revealed that fusion surgery and a small preoperative C2-C7 angle were the independent factors related to motor palsy. Motor palsy involving the lower extremities tended to be found at early time points after the surgery, and all the patients fully recovered. Motor palsy in the upper extremities occurred in a delayed manner, and 68.8% of patients with PDF showed good recovery, whereas 81.3% of patients with LAMP showed good recovery. CONCLUSIONS: In posterior surgeries for cervical OPLL, segmental motor palsy in the upper extremity was most frequently observed, especially in patients who received PDF. Fusion and a small preoperative C2-C7 angle were the independent risk factors for motor palsy. LEVEL OF EVIDENCE: Level III.
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U2 - 10.1097/BSD.0000000000001243
DO - 10.1097/BSD.0000000000001243
M3 - Article
C2 - 34347632
AN - SCOPUS:85122487873
SN - 2380-0186
VL - 34
SP - E594-E600
JO - Clinical Spine Surgery
JF - Clinical Spine Surgery
IS - 10
ER -