Otomo Nao, Nagoshi Narihito, Yamane Junichi, Kono Hitoshi, Miyamoto Azusa, Takeda Kazuki, Yamamoto Tatsuya, Shibata Reo, Nishimura Soraya, Kamata Yasuhiro, Daimon Kenshi, Okubo Toshiki, Kobayashi Yoshiomi, Iga Takahito, Suzuki Satoshi, Ozaki Masahiro, Matsumoto Morio, Nakamura Masaya, Watanabe Kota
Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Tokyo, Japan.
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Global Spine J. 2025 Jun 1:21925682251347507. doi: 10.1177/21925682251347507.
Study DesignRetrospective multi-institutional study.ObjectivesAlthough previous studies have evaluated the surgical outcomes of laminoplasty in patients with cervical ossification of the posterior longitudinal ligament (OPLL), the long-term results remain unclear. The purpose of this study is to assess outcomes more than 10 years post-surgery and identify to identify factors that affect the long-term prognosis.MethodsEighty-four OPLL patients with more than a minimum of 10-year follow-up after surgery were divided into a good group with more than 50% improvement of the recovery rate of the cervical Japanese Orthopaedic Association (JOA) score, and a poor group with less than 50% improvement. The demographic data and radiographic parameters of cervical spinal alignment were compared, and significant poor prognostic factors were evaluated by multivariate logistic regression.ResultsFour preoperative factors showed significant differences between 2 groups: the presence of type 2 diabetes ( = 0.012), the baseline JOA scores ( = 0.001), the narrowest segment in the cervical ( < 0.001) and the presence of T2-weighted high signal on MRI ( = 0.030). Logistic regression analysis identified 3 of 4 factors were significantly associated with postoperative poor outcomes: the presence of type 2 diabetes ( = 0.011), the baseline JOA scores ( = 0.022), and the presence of T2-weighted high signal on MRI ( = 0.035).ConclusionThis study identified three risk factors associated with poor long-term surgical outcomes following laminoplasty for cervical OPLL. These findings could be significant indicators for predicting long-term outcomes in cervical OPLL patients.
研究设计
回顾性多机构研究。
目的
尽管先前的研究已经评估了后纵韧带骨化症（OPLL）患者行椎板成形术的手术效果，但长期结果仍不明确。本研究的目的是评估手术后10年以上的结果，并确定影响长期预后的因素。
方法
84例接受手术且随访至少10年的OPLL患者被分为恢复良好组（日本骨科协会（JOA）颈椎评分恢复率提高超过50%）和恢复较差组（恢复率提高低于50%）。比较两组的人口统计学数据和颈椎排列的影像学参数，并通过多因素逻辑回归评估显著的不良预后因素。
结果
术前4个因素在两组间存在显著差异：2型糖尿病的存在（P = 0.012）、基线JOA评分（P = 0.001）、颈椎最窄节段（P < 0.001）以及MRI上T2加权高信号的存在（P = 0.030）。逻辑回归分析确定4个因素中的3个与术后不良结果显著相关：2型糖尿病的存在（P = 0.011）、基线JOA评分（P = 0.022）以及MRI上T2加权高信号的存在（P = 0.035）。
结论
本研究确定了与颈椎OPLL椎板成形术后长期手术效果不佳相关的三个危险因素。这些发现可能是预测颈椎OPLL患者长期结果的重要指标。
