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  • Ovid Technologies (Wolters Kluwer Health)  (4)
  • Ando, Kei  (4)
  • 1
    Online Resource
    Online Resource
    Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (−) Cervical Ossification of the Posterior Longitudinal Ligament : A Prospective Multicenter Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Spine Vol. 48, No. 13 ( 2023-07-1), p. 937-943
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. 13 ( 2023-07-1), p. 937-943
    Abstract: A prospective multicenter study. Objective. The objective of this study is to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (−) cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data. Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (−) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined. Materials and Methods. A total of 478 patients with myelopathy due to cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for two years. Of the 478 patients, 45 and 46 with K-line (−) underwent anterior and posterior fusion surgeries, respectively. After adjusting for confounders in baseline characteristics using a propensity score-matched analysis, 54 patients in both the anterior and posterior groups (27 patients each) were evaluated. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. Results. Both approaches showed comparable neurological and functional recovery. The cervical range of motion was significantly restricted in the posterior group because of the large number of fused vertebrae compared with the anterior group. The incidence of surgical complications was comparable between the cohorts, but the posterior group demonstrated a higher frequency of segmental motor paralysis, whereas the anterior group more frequently reported postoperative dysphagia. Conclusions. Clinical improvement was comparable between anterior and posterior fusion surgeries for patients with K-line (−) OPLL. The ideal surgical approach should be informed based on the balance between the surgeon’s technical preference and the risk of complications.
    Type of Medium: Online Resource
    ISSN: 0362-2436
    URL: Article
    DOI: 10.1097/BRS.0000000000004634
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2002195-1
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  • 2
    Online Resource
    Online Resource
    Clinical Indicators of Surgical Outcomes After Laminoplasty for Patients With Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Spine Vol. 47, No. 15 ( 2022-08-1), p. 1077-1083
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 15 ( 2022-08-1), p. 1077-1083
    Abstract: A prospective multicenter study. Objective. This study aims to evaluate patient-reported outcomes using the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and clarify clinical factors that affect the therapeutic effects for patients with cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data. Although previous studies identified factors that affected the surgical outcomes, their assessment was mainly based on the Japanese Orthopedic Association score, which only includes neurological function. Investigating this pathology through multiple functions and quality of life (QOL) is pivotal to understanding the comprehensive clinical pictures of the cervical OPLL and its therapeutic outcomes. Materials and Methods. This study was performed by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. A total of 478 patients with myelopathy caused by cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for 2 years. Of the patients, 168 received laminoplasties and fully completed questionnaires. Demographic information, imaging findings, and clinical outcomes were collected. Patients were grouped according to effective or ineffective surgical outcomes as defined by the JOACMEQ using logistic regression analyses. Results. Laminoplasty resulted in functional improvement in the cervical spine and upper extremity around 40% of the patients, while QOL showed only 21.4% ( P 〈 0.01). Multivariable analyses revealed that younger age and a postoperative decrease in arm or hand pain were correlated with significantly improved function of the upper extremities. A reduction in lower limb pain favorably affected the postoperative lower extremity function. A postoperative reduction in upper extremity pain enhanced the QOL recovery. Conclusions. Surgeons should recognize the diversity of surgical outcomes after laminoplasty and understand the necessity of pain management even after the surgery to enhance bodily functions and QOL in patients with cervical OPLL.
    Type of Medium: Online Resource
    ISSN: 0362-2436
    URL: Article
    DOI: 10.1097/BRS.0000000000004359
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2002195-1
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  • 3
    Online Resource
    Online Resource
    Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures After Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Spine Vol. 48, No. 18 ( 2023-09-15), p. 1259-1265
    Details
    In: Spine, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. 18 ( 2023-09-15), p. 1259-1265
    Abstract: 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.
    Type of Medium: Online Resource
    ISSN: 0362-2436
    URL: Article
    DOI: 10.1097/BRS.0000000000004762
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2002195-1
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  • 4
    Online Resource
    Online Resource
    Risk Factor for Poor Patient Satisfaction After Lumbar Spine Surgery in Elderly Patients Aged Over 80 years
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Clinical Spine Surgery: A Spine Publication Vol. 34, No. 4 ( 2021-05), p. E223-E228
    Details
    In: Clinical Spine Surgery: A Spine Publication, Ovid Technologies (Wolters Kluwer Health), Vol. 34, No. 4 ( 2021-05), p. E223-E228
    Abstract: Retrospective cohort study. Objective: To clarify the poor patient satisfaction after lumbar spinal surgery in elderly patients. Summary of Background Data: As the global population continues to age, it is important to consider the surgical outcome and patient satisfaction in the elderly. No studies have assessed patient satisfaction in elderly patients undergoing surgical treatment and risk factors for poor satisfaction in elderly patients after lumbar spinal surgery. Materials and Methods: A retrospective multicenter survey was performed in 169 patients aged above 80 years who underwent lumbar spinal surgery. Patients were followed up for at least 1 year after surgery. We assessed patient satisfaction from the results of surgery by using a newly developed patient questionnaire. Patients were assessed by demographic data, surgical procedures, complications, reoperation rate, pain improvement, and risk factors for poor patient satisfaction with surgery for lumbar spinal disease. Results: In total, 131 patients (77.5%, G-group) were satisfied and 38 patients (22.5%, P-group) were dissatisfied with surgery. The 2 groups did not differ significantly in baseline characteristics and surgical data. Postoperative visual analog scale score for low back pain and leg pain were significantly higher in the P-group than in the G-group (low back pain: G-group, 1.7±1.9 vs. P-group, 5.2±2.5, P 〈 0.001; leg pain: G-group, 1.4±2.0 vs. P-group, 5.5±2.6, P 〈 0.001). Multivariate regression analysis revealed that postoperative vertebral fracture ( P =0.049; odds ratio, 3.096; 95% confidence interval, 1.004–9.547) and reoperation ( P =0.025; odds ratio, 5.692; 95% confidence interval, 1.250–25.913) were significantly associated with the patient satisfaction after lumbar spinal surgery. Conclusions: Postoperative vertebral fracture and reoperation were found to be risk factors for poor patient satisfaction after lumbar spinal surgery in elderly patients, which suggests a need for careful treatment of osteoporosis in addition to careful determination of surgical indication and procedure in elderly patients. Level of Evidence: Level III.
    Type of Medium: Online Resource
    ISSN: 2380-0186
    URL: Article
    DOI: 10.1097/BSD.0000000000001101
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2849652-8
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