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Comparative Study
. 2024 May 1;37(4):170-177.
doi: 10.1097/BSD.0000000000001612. Epub 2024 Apr 19.

Comparison of Postoperative Complications and Outcomes in Anterior Cervical Spine Surgery: Ossification of the Posterior Longitudinal Ligament Versus Cervical Spondylotic Myelopathy

Motonori Hashimoto  1 , Takashi Hirai  1 , Kenichiro Sakai  2 , Kentaro Yamada  1 , Kentaro Sakaeda  1 , Jun Hashimoto  1 , Satoru Egawa  1 , Shingo Morishita  1 , Yu Matsukura  1 , Hiroyuki Inose  1 , Yutaka Kobayashi  2 , Hiroaki Onuma  2 , Kyohei Sakaki  2 , Masaki Tomori  2 , Ichiro Torigoe  2 , Miharu Ochi  3 , Hiroki Ishiguro  3 , Satoshi Tamura  3 , Shuta Ushio  3 , Tsuyoshi Yamada  3 , Norihiko Miyake  3 , Kazuo Kusano  3 , Kazuyuki Otani  3 , Shigeo Shindo  3 , Yoshiyasu Arai  2 , Atsushi Okawa  1 , Toshitaka Yoshii  1
Affiliations
Comparative Study

Comparison of Postoperative Complications and Outcomes in Anterior Cervical Spine Surgery: Ossification of the Posterior Longitudinal Ligament Versus Cervical Spondylotic Myelopathy

Motonori Hashimoto et al. Clin Spine Surg. .

Abstract

Study design: Retrospective cohort study.

Objectives: To compare the frequency of complications and outcomes between patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine and those with cervical spondylotic myelopathy (CSM) who underwent anterior surgery.

Summary of background data: Anterior cervical spine surgery for OPLL is an effective surgical procedure; however, it is complex and technically demanding compared with the procedure for CSM. Few reports have compared postoperative complications and clinical outcomes after anterior surgeries between the 2 pathologies.

Methods: Among 1434 patients who underwent anterior cervical spine surgery at 3 spine centers within the same spine research group from January 2011 to March 2021, 333 patients with OPLL and 488 patients with CSM were retrospectively evaluated. Demographics, postoperative complications, and outcomes were reviewed by analyzing medical records. In-hospital and postdischarge postoperative complications were investigated. Postoperative outcomes were evaluated 1 year after the surgery using the Japanese Orthopaedic Association score.

Results: Patients with OPLL had more comorbid diabetes mellitus preoperatively than patients with CSM ( P <0.001). Anterior cervical corpectomies were more often performed in patients with OPLL than in those with CSM (73.3% and 14.5%). In-hospital complications, such as reoperation, cerebrospinal fluid leak, C5 palsy, graft complications, hoarseness, and upper airway complications, occurred significantly more often in patients with OPLL. Complications after discharge, such as complications of the graft bone/cage and hoarseness, were significantly more common in patients with OPLL. The recovery rate of the Japanese Orthopaedic Association score 1 year postoperatively was similar between patients with OPLL and those with CSM.

Conclusion: The present study demonstrated that complications, both in-hospital and after discharge following anterior spine surgery, occurred more frequently in patients with OPLL than in those with CSM.

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Conflict of interest statement

The authors declare no conflict of interest.

References

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