{"title":"颈椎后纵韧带骨化症患者术前颈部疼痛是否会影响后路减压术后的临床效果?","authors":"Toshiki Okubo, Narihito Nagoshi, Takahito Iga, Takashi Tsuji, Yosuke Horiuchi, Kazuya Kitamura, Kenshi Daimon, Haruki Funao, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Osahiko Tsuji, Morio Matsumoto, Masaya Nakamura, Kota Watanabe, Ken Ishii, Junichi Yamane","doi":"10.1038/s41393-024-01027-z","DOIUrl":null,"url":null,"abstract":"Retrospective multicenter study. To evaluate how preoperative neck pain influences clinical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL). Fourteen medical institutions in Japan. We enrolled 90 patients with cervical OPLL who underwent posterior decompression and were followed for a minimum of two years. We collected demographic data, medical history, and imaging findings. Patients were divided into two groups based on preoperative neck pain presence (Pre-op. neck pain (−) and (+) groups), and their outcomes were compared. There were no significant differences in patient demographics between the Pre-op. neck pain (−) and (+) groups. Both groups showed similar distributions of ossification types and K-line positivity. Perioperative complications were comparable between the two groups. Radiographic analysis revealed no significant differences in C2–7 angles or cervical range of motion, pre- and postoperatively. Both groups demonstrated significant improvement in postoperative Japanese orthopedic association (JOA) scores, but there were no significant differences in scores or recovery rates. In the Pre-op. neck pain (−) group, factors associated with appearance of postoperative neck pain included pre- and postoperative lower JOA scores and larger C2–7 angles in neutral and extension positions. It emerges that lower pre- and postoperative JOA scores or larger C2–7 angles in neutral and extension positions predispose to postoperative neck pain even in those patients without preoperative neck pain. Therefore, this is worth discussing at the time of consenting patients for surgical decompression and fixation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 11","pages":"619-624"},"PeriodicalIF":2.1000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does the presence of preoperative neck pain impact clinical outcomes after posterior decompression in patients with cervical ossification of the posterior longitudinal ligament?: Retrospective multicenter cohort study\",\"authors\":\"Toshiki Okubo, Narihito Nagoshi, Takahito Iga, Takashi Tsuji, Yosuke Horiuchi, Kazuya Kitamura, Kenshi Daimon, Haruki Funao, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Osahiko Tsuji, Morio Matsumoto, Masaya Nakamura, Kota Watanabe, Ken Ishii, Junichi Yamane\",\"doi\":\"10.1038/s41393-024-01027-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Retrospective multicenter study. To evaluate how preoperative neck pain influences clinical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL). Fourteen medical institutions in Japan. We enrolled 90 patients with cervical OPLL who underwent posterior decompression and were followed for a minimum of two years. We collected demographic data, medical history, and imaging findings. Patients were divided into two groups based on preoperative neck pain presence (Pre-op. neck pain (−) and (+) groups), and their outcomes were compared. There were no significant differences in patient demographics between the Pre-op. neck pain (−) and (+) groups. Both groups showed similar distributions of ossification types and K-line positivity. Perioperative complications were comparable between the two groups. Radiographic analysis revealed no significant differences in C2–7 angles or cervical range of motion, pre- and postoperatively. Both groups demonstrated significant improvement in postoperative Japanese orthopedic association (JOA) scores, but there were no significant differences in scores or recovery rates. In the Pre-op. neck pain (−) group, factors associated with appearance of postoperative neck pain included pre- and postoperative lower JOA scores and larger C2–7 angles in neutral and extension positions. It emerges that lower pre- and postoperative JOA scores or larger C2–7 angles in neutral and extension positions predispose to postoperative neck pain even in those patients without preoperative neck pain. Therefore, this is worth discussing at the time of consenting patients for surgical decompression and fixation.\",\"PeriodicalId\":21976,\"journal\":{\"name\":\"Spinal cord\",\"volume\":\"62 11\",\"pages\":\"619-624\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spinal cord\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.nature.com/articles/s41393-024-01027-z\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spinal cord","FirstCategoryId":"3","ListUrlMain":"https://www.nature.com/articles/s41393-024-01027-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Does the presence of preoperative neck pain impact clinical outcomes after posterior decompression in patients with cervical ossification of the posterior longitudinal ligament?: Retrospective multicenter cohort study
Retrospective multicenter study. To evaluate how preoperative neck pain influences clinical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL). Fourteen medical institutions in Japan. We enrolled 90 patients with cervical OPLL who underwent posterior decompression and were followed for a minimum of two years. We collected demographic data, medical history, and imaging findings. Patients were divided into two groups based on preoperative neck pain presence (Pre-op. neck pain (−) and (+) groups), and their outcomes were compared. There were no significant differences in patient demographics between the Pre-op. neck pain (−) and (+) groups. Both groups showed similar distributions of ossification types and K-line positivity. Perioperative complications were comparable between the two groups. Radiographic analysis revealed no significant differences in C2–7 angles or cervical range of motion, pre- and postoperatively. Both groups demonstrated significant improvement in postoperative Japanese orthopedic association (JOA) scores, but there were no significant differences in scores or recovery rates. In the Pre-op. neck pain (−) group, factors associated with appearance of postoperative neck pain included pre- and postoperative lower JOA scores and larger C2–7 angles in neutral and extension positions. It emerges that lower pre- and postoperative JOA scores or larger C2–7 angles in neutral and extension positions predispose to postoperative neck pain even in those patients without preoperative neck pain. Therefore, this is worth discussing at the time of consenting patients for surgical decompression and fixation.
期刊介绍:
Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews.
Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.