Factors Significantly Associated with Postoperative Neck Pain Deterioration after Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Study of a Cohort Using a Prospective Registry

doi:10.3390/jcm10215026

. 2021 Oct 28;10(21):5026.

doi: 10.3390/jcm10215026.

Factors Significantly Associated with Postoperative Neck Pain Deterioration after Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Study of a Cohort Using a Prospective Registry

Masao Koda¹, Toshitaka Yoshii², Satoru Egawa², Kenichiro Sakai³, Kazuo Kusano⁴, Yukihiro Nakagawa⁵, Takashi Hirai², Kanichiro Wada⁶, Keiichi Katsumi⁷, Atsushi Kimura⁸, Takeo Furuya⁹, Satoshi Maki⁹, Narihito Nagoshi¹⁰, Kota Watanabe¹⁰, Tsukasa Kanchiku¹¹, Yukitaka Nagamoto¹², Yasushi Oshima¹³, Kei Ando¹⁴, Hiroaki Nakashima¹⁴, Masahiko Takahata¹⁵, Kanji Mori¹⁶, Hideaki Nakajima¹⁷, Kazuma Murata¹⁸, Shunji Matsunaga¹⁹, Takashi Kaito²⁰, Kei Yamada²¹, Sho Kobayashi²², Satoshi Kato²³, Tetsuro Ohba²⁴, Satoshi Inami²⁵, Shunsuke Fujibayashi²⁶, Hiroyuki Katoh²⁷, Haruo Kanno²⁸, Hiroshi Takahashi¹, Kengo Fujii¹, Masayuki Miyagi²⁹, Gen Inoue²⁹, Masashi Takaso²⁹, Shiro Imagama¹⁴, Yoshiharu Kawaguchi³⁰, Katsushi Takeshita⁸, Masaya Nakamura¹⁰, Morio Matsumoto¹⁰, Atsushi Okawa², Masashi Yamazaki¹

Affiliations

¹ Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.
² Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo 113-8519, Japan.
³ Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchishi, Saitama 332-8558, Japan.
⁴ Department of Orthopedic Surgery, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyodaku, Tokyo 102-0074, Japan.
⁵ Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Itogun, Wakayama 649-7113, Japan.
⁶ Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori 036-8562, Japan.
⁷ Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, 1-754 Asahimachidori, Chuo Ward, Niigata 951-8520, Japan.
⁸ Department of Orthopedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan.
⁹ Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba 260-0856, Japan.
¹⁰ Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku Ward, Tokyo 160-8582, Japan.
¹¹ Department of Orthopedic Surgery, Yamaguchi Rosai Hospital, 1315-4 Onoda, Onoda-City 756-0095, Japan.
¹² Department of Orthopedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Sakaishi 591-8025, Japan.
¹³ Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
¹⁴ Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya 466-8550, Japan.
¹⁵ Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo 060-8638, Japan.
¹⁶ Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu 520-2192, Japan.
¹⁷ Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.
¹⁸ Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
¹⁹ Department of Orthopedic Surgery, Kawamoto Memorial Clinic, 5397-3 Yoshinocho, Kagoshima-City 892-0871, Japan.
²⁰ Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
²¹ Department of Orthopaedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi 830-0011, Japan.
²² Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3125, Japan.
²³ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
²⁴ Department of Orthopedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo Ward, Yamanashi 409-3898, Japan.
²⁵ Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan.
²⁶ Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
²⁷ Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan.
²⁸ Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba Ward, Sendai 980-8574, Japan.
²⁹ Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami Ward, Sagamihara 252-0375, Japan.
³⁰ Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.

PMID: 34768547
PMCID: PMC8584891
DOI: 10.3390/jcm10215026

Factors Significantly Associated with Postoperative Neck Pain Deterioration after Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Study of a Cohort Using a Prospective Registry

Masao Koda et al. J Clin Med. 2021.

. 2021 Oct 28;10(21):5026.

doi: 10.3390/jcm10215026.

Authors

Affiliations

¹ Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.
² Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo 113-8519, Japan.
³ Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchishi, Saitama 332-8558, Japan.
⁴ Department of Orthopedic Surgery, Kudanzaka Hospital, 1-6-12 Kudanminami, Chiyodaku, Tokyo 102-0074, Japan.
⁵ Department of Orthopaedic Surgery, Wakayama Medical University Kihoku Hospital, 219 Myoji, Katsuragi-cho, Itogun, Wakayama 649-7113, Japan.
⁶ Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki, Aomori 036-8562, Japan.
⁷ Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, 1-754 Asahimachidori, Chuo Ward, Niigata 951-8520, Japan.
⁸ Department of Orthopedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan.
⁹ Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo Ward, Chiba 260-0856, Japan.
¹⁰ Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku Ward, Tokyo 160-8582, Japan.
¹¹ Department of Orthopedic Surgery, Yamaguchi Rosai Hospital, 1315-4 Onoda, Onoda-City 756-0095, Japan.
¹² Department of Orthopedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Sakaishi 591-8025, Japan.
¹³ Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
¹⁴ Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya 466-8550, Japan.
¹⁵ Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Sapporo 060-8638, Japan.
¹⁶ Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu 520-2192, Japan.
¹⁷ Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.
¹⁸ Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
¹⁹ Department of Orthopedic Surgery, Kawamoto Memorial Clinic, 5397-3 Yoshinocho, Kagoshima-City 892-0871, Japan.
²⁰ Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
²¹ Department of Orthopaedic Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi 830-0011, Japan.
²² Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3125, Japan.
²³ Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
²⁴ Department of Orthopedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo Ward, Yamanashi 409-3898, Japan.
²⁵ Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan.
²⁶ Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
²⁷ Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan.
²⁸ Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba Ward, Sendai 980-8574, Japan.
²⁹ Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami Ward, Sagamihara 252-0375, Japan.
³⁰ Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.

PMID: 34768547
PMCID: PMC8584891
DOI: 10.3390/jcm10215026

Abstract

Postoperative neck pain has been reported as an unsolved postoperative complication of surgery for cervical ossification of the posterior longitudinal ligament (OPLL). The aim of the present study was to elucidate factors having a significant association with postoperative deterioration of neck pain in cervical OPLL patients. We studied a cohort of patients in a prospective registry of 478 patients who had undergone cervical spine surgery for cervical OPLL. We excluded those without evaluation of preoperative neck pain. Therefore, 438 patients were included in the present study. Neck pain was evaluated with the visual analogue scale (VAS, 0-100 mm). Postoperative neck pain deterioration was defined as a ≥20 mm increase of VAS neck pain. Patient factors, neurological status, imaging factors and surgical factors were assessed. Univariate analyses followed by multivariate analysis using stepwise logistic regression was performed. Six months after surgery, 50 (11.6%) patients showed postoperative neck pain deterioration and 76 (17.4%) patients showed postoperative neck pain deterioration 2 years after surgery. Six months after surgery, the rate of neck pain deterioration was significantly higher in patients who had undergone posterior surgery. Two years after surgery, the number of levels fused was significantly correlated with neck pain deterioration.

Keywords: cervical spine; neck pain; ossification of the posterior longitudinal ligament; surgery.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

**Figure 1**
Patients who had undergone cervical spine surgery for myelopathy caused by cervical OPLL. We excluded those without evaluation of preoperative neck pain. We ultimately included 438 patients with treated cervical OPLL.

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[1] Wu J.C., Chen Y.C., Huang W.C. Ossification of the posterior longitudinal ligament in cervical spine: Prevalence, management, and prognosis. Neurospine. 2018;15:33–41. doi: 10.14245/ns.1836084.042. - DOI - PMC - PubMed

[2] Wu J.C., Chen Y.C., Huang W.C. Ossification of the posterior longitudinal ligament in cervical spine: Prevalence, management, and prognosis. Neurospine. 2018;15:33–41. doi: 10.14245/ns.1836084.042. - DOI - PMC - PubMed

[3] Aljuboori Z., Boakye M. The natural history of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: A review article. Cureus. 2019;11:e5074. doi: 10.7759/cureus.5074. - DOI - PMC - PubMed

[4] Aljuboori Z., Boakye M. The natural history of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: A review article. Cureus. 2019;11:e5074. doi: 10.7759/cureus.5074. - DOI - PMC - PubMed

[5] Boody B.S., Lendner M., Vaccaro A.R. Ossification of the posterior longitudinal ligament in the cervical spine: A review. Int. Orthop. 2019;43:797–805. doi: 10.1007/s00264-018-4106-5. - DOI - PubMed

[6] Boody B.S., Lendner M., Vaccaro A.R. Ossification of the posterior longitudinal ligament in the cervical spine: A review. Int. Orthop. 2019;43:797–805. doi: 10.1007/s00264-018-4106-5. - DOI - PubMed

[7] Wilson J.R., Barry S., Fisher D.J., Skelly A.C., Arnold P.M., Riew K.D., Shaffrey C.I., Traynelis V.C., Fehlings M.G. Frequancy, timing, and predictors of neurological dysfunction in the nonmyelopathic patients with cervical spinal cord compression, canal stenosis, and/or ossification of the posterior longitudinal ligament. Spine. 2013;38:S37–S54. doi: 10.1097/BRS.0b013e3182a7f2e7. - DOI - PubMed

[8] Wilson J.R., Barry S., Fisher D.J., Skelly A.C., Arnold P.M., Riew K.D., Shaffrey C.I., Traynelis V.C., Fehlings M.G. Frequancy, timing, and predictors of neurological dysfunction in the nonmyelopathic patients with cervical spinal cord compression, canal stenosis, and/or ossification of the posterior longitudinal ligament. Spine. 2013;38:S37–S54. doi: 10.1097/BRS.0b013e3182a7f2e7. - DOI - PubMed

[9] Tetreault L., Ibrahim A., Côté P., Singh A., Fehlings M.G. A systematic review of clinical and surgical predictors of complications following surgery for degenerative cervical myelopathy. J. Neurosurg. Spine. 2016;24:77–99. doi: 10.3171/2015.3.SPINE14971. - DOI - PubMed

[10] Tetreault L., Ibrahim A., Côté P., Singh A., Fehlings M.G. A systematic review of clinical and surgical predictors of complications following surgery for degenerative cervical myelopathy. J. Neurosurg. Spine. 2016;24:77–99. doi: 10.3171/2015.3.SPINE14971. - DOI - PubMed

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Factors Significantly Associated with Postoperative Neck Pain Deterioration after Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Study of a Cohort Using a Prospective Registry

Affiliations

Factors Significantly Associated with Postoperative Neck Pain Deterioration after Surgery for Cervical Ossification of the Posterior Longitudinal Ligament: Study of a Cohort Using a Prospective Registry

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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Abstract

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References

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