Clinical Characteristics and Surgical Outcome of Revision Surgery in Patients with Cervical Ossification of the Posterior Longitudinal Ligament

Ha, Yoon; Moon, Bong Ju; You, Nam Kyu; Yoon, Sojung; Shin, Dong Ah; Yi, Seong; Kh, Kim; Shin, Hocheol; Yoon, Do Heum

doi:10.1016/j.wneu.2016.02.054

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…Ultimately, the choice of a surgical approach requires the consideration of numerous radiographic, technical, and patient-specific considerations and numerous algorithms exist to facilitate in this decision-making process and so are not reviewed extensively herein. One such algorithm, proposed by Ha et al [54] (adapted in Table 3), takes into account the extent of OPLL disease (number of levels involved) and occupying ratio to aid in approach selection.…”

Section: Discussionmentioning

confidence: 99%

“…Table summarizing the key portions of the algorithm described by Ha et al, 2016 [54] that involves selecting surgical approach to based on the number of involved levels, the occupying ratio of the OPLL mass, and the presence of kyphotic deformity.OPLL, ossification of the posterior longitudinal ligament; ADF, anterior decompression with floating; ACDF, anterior cervical decompression and fusion.…”

Section: Tablementioning

confidence: 99%

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Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

et al. 2019

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Ossification of the posterior longitudinal ligament (OPLL) is a rare but potentially devastating cause of degenerative cervical myelopathy (DCM). Decompressive surgery is the standard of care for OPLL and can be achieved through anterior, posterior, or combined approaches to the cervical spine. Surgical correction of OPLL via any approach is associated with higher rates of complications and the presence of OPLL is considered a significant risk factor for perioperative complications in DCM surgeries. Potential complications include dural tear (DT) and subsequent cerebrospinal fluid leak, C5 palsy, hematoma, hardware failure, surgical site infections, and other neurological deficits. Anterior approaches are technically more demanding and associated with higher rates of DT but offer greater access to ventral OPLL pathology. Posterior approaches are associated with lower rates of complications but may allow for continued disease progression. Therefore, the decision to pursue either an anterior or posterior approach to surgical decompression may be critically influenced by complications associated with each procedure. The authors critically review anterior and posterior approaches to surgical decompression of OPLL with particular focus on the complications associated with each approach. We also review the recent work in developing new surgical treatments for OPLL that aim to reduce complication incidence.

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Section: Discussionmentioning

confidence: 99%

Section: Tablementioning

confidence: 99%

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

et al. 2019

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“…Another adverse factor on patient dissatisfaction at the long-term is symptom recurrence, which brought the physical and mental impairments to the patients so that the patients are very painful and difficult to accept. Ha Y et al reported that growth of ossification of the posterior longitudinal ligament (50%) was the primary cause of revision surgery and noted that clinical outcomes of revision surgery are similar to the outcomes of patients who did not require revision surgery [24]. So that many of the patients do not have the courage to accept the second operation.…”

Section: Discussionmentioning

confidence: 99%

Analyses of effect factors associated with the postoperative dissatisfaction of patients undergoing open-door laminoplasty for cervical OPLL: a retrospective cohort study

et al. 2019

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Objectives This study aimed to investigate the effect factors associated with the postoperative dissatisfaction of patients undergoing open-door laminoplasty for cervical OPLL. Methods In this study, 194 patients, who underwent open-door laminoplasty for cervical OPLL from January 2009 to January 2016, were retrospectively reviewed. The Patient Satisfaction Index (PSI) was collected at discharge, 6 months, 1 year, and the last follow-up. According to the PSI, patients were divided into satisfied group and dissatisfied group. The possible effect factors included demographic variables and surgery-related variables. Results At discharge, 42 (21.6%) patients were in the dissatisfied group, as compared to the satisfied group, the hospitalization cost, hospital stay, postoperative depression, the axial neck pain, delayed wound healing, and VAS-neck had significant statistical differences. At 6-month follow-up, 25 (12.9%) patients were in the dissatisfied group. The axial neck pain and JOA score had significant statistical differences between the two groups, and no significant differences were found between the two groups in other items. At 1 year with 18 (9.3%) dissatisfied patients and last follow-up with 14 (7.2%) dissatisfied patients, the JOA score and symptom recurrence had significant statistical differences. For further analysis, the dissatisfied patients with axial neck pain at 6 months were significantly higher than that at other terms and the JOA score of the two groups increased gradually with prolonging of restoration years but compared with the dissatisfied group, the JOA scores were obviously better in the satisfied group at the last follow-up. Conclusions Overall, to patients undergoing open-door laminoplasty for cervical OPLL, hospitalization cost and neck pain might be mainly associated with patient dissatisfaction at the early and middle recovery. Patient dissatisfaction at the long-term treatment outcome might be mainly associated with the low improvement rate of JOA score and symptom recurrence.

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“…Spine surgeons have recently tended to prefer posterior surgeries because these surgeries have fewer risks of critical complications than those expected in cervical anterior surgeries, such as retropharyngeal edema and esophageal damage 22) . The reoperation rates of cervical posterior decompression have been reported to be 0.4%-3.8% 11,12,23) . For the reoperation rates of laminoplasty, Ha et al 23) analyzed 339 cases for cervical OPLL and reported a reoperation rate of 3.8% with a mean follow-up period of 26 months.…”

Section: Discussionmentioning

confidence: 99%

“…The reoperation rates of cervical posterior decompression have been reported to be 0.4%-3.8% 11,12,23) . For the reoperation rates of laminoplasty, Ha et al 23) analyzed 339 cases for cervical OPLL and reported a reoperation rate of 3.8% with a mean follow-up period of 26 months. Lee et al 24) analyzed 145 cases with a Cox proportional-hazards regression survivorship curve and reported the overall reoperation rates for adjacent segment disorder as approximately 4% at 10 years.…”

Section: Discussionmentioning

confidence: 99%

Reoperation Rates after Laminoplasty for Cervical Disorders: A 26-Year Period Survival Function Method Analysis

Hashimoto

Aizawa

Ozawa

et al. 2019

Spine Surg Relat Res

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Introduction Laminoplasty is a common surgery for cervical myelopathy. Previous studies have analyzed the reoperation rates in posterior decompression surgeries of the cervical spine. However, few studies have solely focused on midline-splitting laminoplasty (MSL) using a large number of patients. This aims to analyze the reoperation rates after MSL using the survival function method. Methods Between 1988 and 2013, 4,208 MSLs were performed as a primary operation for cervical myelopathy and enrolled in our spinal surgery registration system. The Kaplan-Meier survival function method was used to analyze the rates of reoperation. Results Of 4,208 patients with primary MSL, 40 underwent reoperation for neurological complications. The overall reoperation rate was 0.26%, 0.64%, 0.83%, 0.93%, and 0.95% at 1, 5, 10, 20, and >20 years, respectively. The causes of reoperation were postoperative cervical radiculopathy in 10 patients, stenosis at an adjacent level in 8, stenosis due to failed “open-door” lamina in 6, instability of the cervical spine in 4, cervical disc herniation in 3, elongation of ossification of the posterior longitudinal ligament in 3, spinal cord injury in 1, fracture of the cervical spine in 1, postoperative scar formation in 1, ossification of anterior longitudinal ligament in 1, and unknown in 2. The number of patients with surgical site infection (SSI) who needed surgical debridement was 34 (0.81%). Conclusions Excluding reoperations for SSI, the reoperation rate of MSL was approximately 1.0% at the maximum of 26 years after surgery. MSL was determined to be a reliable surgical procedure regarding postoperative complications requiring additional surgeries.

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Clinical Characteristics and Surgical Outcome of Revision Surgery in Patients with Cervical Ossification of the Posterior Longitudinal Ligament

Cited by 14 publications

References 22 publications

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications

Analyses of effect factors associated with the postoperative dissatisfaction of patients undergoing open-door laminoplasty for cervical OPLL: a retrospective cohort study

Reoperation Rates after Laminoplasty for Cervical Disorders: A 26-Year Period Survival Function Method Analysis

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