scholarly journals The impact of ossification spread on cervical spine function in patients with ossification of the posterior longitudinal ligament

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Keiichi Katsumi ◽  
Takashi Hirai ◽  
Toshitaka Yoshii ◽  
Satoshi Maki ◽  
Kanji Mori ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Multicenter Study ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Multivariate Regression Analysis ◽  
Adverse Outcomes ◽  
Prospective Multicenter Study ◽  
Spine Function ◽  
Whole Spine ◽  
The Impact

AbstractOssification of the posterior longitudinal ligament (OPLL) is a progressive disease. The bridging of ossified lesions to the vertebral body gradually increases, thereby decreasing the mobility of the cervical spine; thus, cervical spine function may decrease over time. However, cervical spine function in patients with cervical OPLL has not been evaluated in large prospective studies. Therefore, we conducted a prospective multicenter study to clarify whether ossification spread can influence cervical spine function and quality of life (QOL) in patients with cervical OPLL. In total, 238 patients (162 men, 76 women; mean age, 63.9 years) were enrolled from 16 institutions. Each patient underwent whole spine computed tomography and was evaluated for cervical spine function and QOL using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). In the multivariate regression analysis, a higher neck VAS score and a larger number of bridge formations of OPLL in the whole spine were significant predictors of adverse outcomes related to cervical spine function. This is the first prospective multicenter study to reveal the impact of ossification spread on cervical spine function. These findings are important to understand the natural course of OPLL and can serve as controls when evaluating postoperative cervical spine function.

scholarly journals The Impact of Ossification Spread on Cervical Spine Function in Patients With Ossification of The Posterior Longitudinal Ligament

2021 ◽  
Author(s):  
Keiichi Katsumi ◽  
Takashi Hirai ◽  
Toshitaka Yoshii ◽  
Satoshi Maki ◽  
Kanji Mori ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Multicenter Study ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Multivariate Regression Analysis ◽  
Adverse Outcomes ◽  
Prospective Multicenter Study ◽  
Spine Function ◽  
Whole Spine ◽  
The Impact

Abstract Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. The bridging of ossified lesions to the vertebral body gradually increases, thereby decreasing the mobility of the cervical spine; thus, cervical spine function may decrease over time. However, cervical spine function in patients with cervical OPLL has not been evaluated in large prospective studies. Therefore, we conducted a prospective multicenter study to clarify whether ossification spread can influence cervical spine function and quality of life (QOL) in patients with cervical OPLL. In total, 238 patients (162 men, 76 women; mean age, 63.9 years) were enrolled from 16 institutions. Each patient underwent whole spine computed tomography and was evaluated cervical spine function and QOL using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). In the multivariate regression analysis, a higher neck VAS score and a larger number of bridge formations of OPLL in the whole spine were significant predictors of adverse outcomes related to cervical spine function. This is the first prospective multicenter study to reveal the impact of ossification spread on cervical spine function. These findings are important to understand the natural course of OPLL and can serve as controls when evaluating postoperative cervical spine function.

scholarly journals Does Diabetes Affect the Surgical Outcomes in Cases With Cervical Ossification of the Posterior Longitudinal Ligament? A Multicenter Study From Asia Pacific Spine Study Group

2021 ◽  
pp. 219256822199630
Author(s):  
Narihito Nagoshi ◽  
Kota Watanabe ◽  
Masaya Nakamura ◽  
Morio Matsumoto ◽  
Nan Li ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Surgical Outcomes ◽  
Hemoglobin A1c ◽  
Perioperative Complications ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Asia Pacific ◽  
C5 Palsy ◽  
Significant Difference ◽  
The Impact

Study Design: Retrospective multicenter study. Objectives: To evaluate the surgical outcomes of cervical ossification of the posterior longitudinal ligament (OPLL) in diabetes mellitus (DM) patients. Methods: Approximately 253 cervical OPLL patients who underwent surgical decompression with or without fixation were registered at 4 institutions in 3 Asian countries. They were followed up for at least 2 years. Demographics, imaging, and surgical information were collected, and cervical Japanese Orthopaedic Association (JOA) scores and the visual analog scale (VAS) for the neck were used for evaluation. Results: Forty-seven patients had DM, showing higher hypertension and cardiovascular disease prevalence. Although they presented worse preoperative JOA scores than non-DM patients (10.5 ± 3.1 vs. 11.8 ± 3.2; P = 0.01), the former showed comparable neurologic recovery at the final follow-up (13.9 ± 2.9 vs. 14.2 ± 2.6; P = 0.41). No correlation was noted between the hemoglobin A1c level in the DM group and the pre- and postoperative JOA scores. No significant difference was noted in VAS scores between the groups at pre- and postsurgery. Regarding perioperative complications, DM patients presented a higher C5 palsy frequency (14.9% vs. 5.8%; P = 0.04). A similar trend was observed when surgical procedure was limited to laminoplasty. Conclusions: This is the first multicenter Asian study to evaluate the impact of DM on cervical OPLL patients. Surgical results were favorable even in DM cases, regardless of preoperative hemoglobin A1c levels or operative procedures. However, caution is warranted for the occurrence of C5 palsy after surgery.

scholarly journals Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Vol 10 (15) ◽  
pp. 3375
Author(s):  
Atsushi Kimura ◽  
Katsushi Takeshita ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Takashi Hirai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cervical Spine ◽  
Postoperative Complications ◽  
Spine Surgery ◽  
Posterior Longitudinal Ligament ◽  
Lower Extremity Function ◽  
Cervical Spine Surgery ◽  
The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

The impact of the Harmonic FOCUS™ on complications in thyroid surgery: a prospective multicenter study

2013 ◽  
Vol 65 (4) ◽  
pp. 295-299 ◽  
Author(s):  
Gabriele Materazzi ◽  
Giuseppe Caravaglios ◽  
Valeria Matteucci ◽  
Aleksandr Aghababyan ◽  
Mario Miccoli ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Thyroid Surgery ◽  
Prospective Multicenter Study ◽  
Harmonic Focus ◽  
The Impact

scholarly journals Cervical Myelopathy Caused by Non-Rheumatic Retro-Odontoid Pseudotumor: An Investigation of Underlying Mechanisms and Optimal Surgical Strategy

2022 ◽  
pp. 219256822110695
Author(s):  
Masahiko Takahata ◽  
Ryota Hyakkan ◽  
Shigeki Oshima ◽  
Itaru Oda ◽  
Masahiro Kanayama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Surgical Procedures ◽  
Cervical Myelopathy ◽  
Multivariate Regression Analysis ◽  
Surgical Strategy ◽  
Control Group ◽  
Retrospective Case ◽  
Subaxial Cervical Spine ◽  
Spine Function

Study Design Retrospective case-control study. Objective This study aimed to identify the underlying pathologies of non-rheumatic retro-odontoid pseudotumors (NRPs), which would help establish an appropriate surgical strategy for myelopathy caused by NRP. Methods We identified 35 patients with myelopathy caused by NRP who underwent surgery between 2006 and 2017. An age- and sex-matched control group of 70 subjects was selected from patients with degenerative cervical myelopathy. Radiographic risk factors for NRP were compared between cases and controls. We also assessed surgical outcomes following occipital-cervical (O-C) fusion, atlantoaxial (C1-2) fusion, or C1 laminectomy. Results Patients with NRP had significantly lower C1 sagittal inner diameter, C2-7 range of motion (ROM), C2-7 Cobb angle, and C7 tilt, as well as significantly higher C1-2 ROM, atlantodental interval (ADI), and C1-2 to O-C7 ROM ratio. Multivariate regression analysis revealed that ADI, C2-7 ROM, and C7 tilt were independent risk factors for NRP. Neurological recovery and pseudotumor size reduction were comparable among surgical procedures, whereas post-operative cervical spine function was significantly lower in the O-C fusion group than in the other groups. Conclusion Non-rheumatic retro-odontoid pseudotumor was associated with an increase in ADI, suggesting that spinal arthrodesis surgery is a reasonable strategy for NRP. C1-2 fusion is preferable over O-C fusion because of the high prevalence of ankylosis in the subaxial cervical spine. Given that 29% of patients with NRP have C1 hypoplasia, such cases can be treated by posterior decompression alone. Our study highlights the need to select appropriate surgical procedures based on the underlying pathology in each case.

Spinal stenosis due to ossified lumbar lesions

2005 ◽  
Vol 3 (4) ◽  
pp. 262-270 ◽  
Author(s):  
Yoshiharu Kawaguchi ◽  
Takeshi Oya ◽  
Yumiko Abe ◽  
Masahiko Kanamori ◽  
Hirokazu Ishihara ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Neurological Deterioration ◽  
Surgical Results ◽  
Content Type ◽  
Spinal Lesions ◽  
Whole Spine ◽  
Fine Print

Object. Spinal stenosis due to lumbar ossified lesions is a rare pathological entity. The authors retrospectively evaluated the clinical features and surgical results associated with cases involving lumbar ossified lesion—induced stenosis. Methods. Data obtained in 20 surgically treated patients with lumbar hyperostotic spinal stenosis were included. To evaluate the background of the disease, body mass index and general complications were assessed. Whole-spine radiological examination was conducted. The presence of ossification of the posterior longitudinal ligament or ossification of the ligamentum flavum was evaluated. Surgical results were classified according to the Japanese Orthopaedic Association (JOA) scale. In the patients in whom neurological deterioration was observed during follow up, the causes of deterioration were reviewed. Seven patients (35%) were obese and six patients (30%) suffered diabetes mellitus. Twelve patients harbored coexisting cervical and/or thoracic ossified lesions. The overall mean JOA score improved from 10.2 to a peak of 22.5; at last follow-up examination the mean JOA score was 20.9. In female and older patients with a long history of preoperative symptoms, a low preoperative JOA score, and other spinal lesions, recovery tended to be poorer. Recovery was poor in one patient, and neurological deterioration due to coexisting ossified spinal lesions occurred in another patient during the follow-up period. Conclusions. Because coexisting ossified lesions were frequently seen, whole-spine analysis is recommended. Early diagnosis and appropriate treatment are important to achieve a better surgical outcome.

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