Okubo Toshiki, Nagoshi Narihito, Kono Hitoshi, Nojiri Kenya, Fukuda Kentaro, Ikegami Takeshi, Tsuji Takashi, Horiuchi Yosuke, Iga Takahito, Takeda Kazuki, Ozaki Masahiro, Suzuki Satoshi, Matsumoto Morio, Nakamura Masaya, Watanabe Kota, Ishii Ken, Yamane Junichi
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Keio Spine Research Group (KSRG), Tokyo, Japan.
Global Spine J. 2025 May;15(4):2255-2264. doi: 10.1177/21925682241296456. Epub 2024 Oct 21.
Study DesignRetrospective multicenter study.ObjectivesTo investigate the impact of preoperative cervical range of motion (ROM) on clinical outcomes after posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL).MethodsWe analyzed data from 156 patients with cervical OPLL who underwent posterior decompression and were followed for at least 2 years. Patients were divided into two groups based on preoperative gap ROM, which was a novel indicator representing the difference between flexion and extension ROM: the gROM <0° and >0° groups, and their outcomes were compared.ResultsThere were no significant differences in patient demographics or surgical details between the gROM <0° and >0° groups. The gROM <0° group exhibited less lordosis in C2-7 angles before and after surgery compared to the gROM >0° group. Cervical ROM significantly decreased following posterior decompression regardless of whether preoperative gROM was <0° or >0°. Meanwhile, the incidence of perioperative complications was similar between the two groups. Furthermore, both groups showed significant improvement in Japanese Orthopaedic Association (JOA) scores postoperatively; however, there were no significant group differences in JOA scores, recovery rates, or visual analog scale for neck pain between the two groups at the preoperation and final follow-up.ConclusionsThe incidence of perioperative complications and postoperative clinical outcomes were comparable regardless of the magnitude of preoperative cervical gROM. Although cervical ROM decrease postoperatively, posterior decompression for cervical OPLL can offer favorable clinical outcomes irrespective of the preoperative cervical ROM magnitude, consequently.
研究设计
回顾性多中心研究。
目的
探讨术前颈椎活动度(ROM)对后纵韧带骨化症(OPLL)后路减压术后临床疗效的影响。
方法
我们分析了156例行后路减压且随访至少2年的颈椎OPLL患者的数据。根据术前间隙ROM(一种代表屈伸ROM差异的新指标)将患者分为两组:gROM <0°组和>0°组,并比较两组的疗效。
结果
gROM <0°组和>0°组在患者人口统计学或手术细节方面无显著差异。与gROM >0°组相比,gROM <0°组在手术前后C2-7角度的前凸角度较小。无论术前gROM是<0°还是>0°,后路减压后颈椎ROM均显著降低。同时,两组围手术期并发症的发生率相似。此外,两组术后日本骨科协会(JOA)评分均显著改善;然而,两组在术前和最终随访时的JOA评分、恢复率或颈部疼痛视觉模拟量表方面均无显著组间差异。
结论
无论术前颈椎gROM大小如何,围手术期并发症的发生率和术后临床疗效相当。尽管术后颈椎ROM降低,但颈椎OPLL后路减压术无论术前颈椎ROM大小如何均可提供良好的临床疗效。