Factors Affecting the Surgical Outcomes of Patients Treated With "de-tension" Surgical Strategy for Multilevel Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine: A Minimum 2-year Follow-Up Study of 83 Patients in a Single Center.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-11-01 Epub Date: 2023-05-06 DOI:10.1177/21925682231174194

Guanghui Chen, Tianqi Fan, Zhongqiang Chen, Weishi Li, Qiang Qi, Zhaoqing Guo, Woquan Zhong, Yu Jiang, Chunli Song, Chuiguo Sun

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Abstract

Study design: Retrospective cohort study.

Objectives: To describe the clinical characteristics and surgical outcomes of patients with multilevel-ossification of the posterior longitudinal ligament (mT-OPLL), and to identify risk factors for unfavorable outcomes.

Methods: Patients who were diagnosed with mT-OPLL and underwent one-stage thoracic posterior laminectomy combined with selective OPLL resection, spinal cord de-tension, and fusion surgery between August 2012 and October 2020 were recruited. Patients' demographic-, surgical- and radiological-related parameters were collected and analyzed. Neurological status was evaluated with mJOA score, and recovery rate (RR) was calculated using the Hirabayashi formula. According to RR, patients were divided into a favorable outcome group (FOG, RR ≥50%) and an unfavorable outcome group (UOG, RR <50%). Univariate and multivariate analyses were used to compare the difference between the 2 groups and to identify risk factors for unfavorable outcomes.

Results: A total of 83 patients were included, with an average age of 50.6 ± 8.3 years. Cerebrospinal fluid leakage (60.2%) and transient neurological deterioration (9.6%) were the most common complications. The average mJOA score improved from preoperative 4.3 ± 2.2 to 9.0 ± 2.4 at the last follow-up, and the mean RR was 74.9 ± 26.3%. Disease duration, preoperative nonambulatory status, and the number of decompressed levels were identified as potential risk factors by Univariate analysis (all P < .05). Multivariate analysis showed that the preoperative disease duration and nonambulatory status were independent risk factors for unfavorable outcomes.

Conclusions: Long disease duration and nonambulatory status before surgery were independent risk factors for unfavorable outcomes.

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影响采用 "去张力 "手术策略治疗胸椎后纵韧带多层骨化患者手术疗效的因素：单个中心 83 例患者的至少 2 年随访研究。

研究设计回顾性队列研究：描述后纵韧带多水平缺损（mT-OPLL）患者的临床特征和手术结果，并确定不利结果的风险因素：方法：招募2012年8月至2020年10月期间确诊为mT-OPLL并接受一期胸椎后椎板切除术联合选择性OPLL切除术、脊髓去张力术和融合术的患者。收集并分析了患者的人口统计学、手术和放射学相关参数。用mJOA评分评估神经功能状态，并用平林公式计算康复率（RR）。根据 RR，患者被分为有利结果组（FOG，RR ≥50%）和不利结果组（UOG，RR 结果）：共纳入 83 例患者，平均年龄（50.6±8.3）岁。脑脊液漏（60.2%）和一过性神经功能恶化（9.6%）是最常见的并发症。平均 mJOA 评分从术前的 4.3 ± 2.2 提高到最后一次随访时的 9.0 ± 2.4，平均 RR 为 74.9 ± 26.3%。通过单变量分析发现，病程、术前不能行走的状态和减压水平的数量是潜在的风险因素（P 均小于 0.05）。多变量分析表明，术前病程和不行动状态是导致不利结果的独立风险因素：结论：术前病程长和不能行走是导致不良预后的独立风险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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