Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures after Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament

Yu Matsukura; Satoru Egawa; Hiroyuki Inose; Kenichiro Sakai; Kazuo Kusano; Shunji Tsutsui; Takashi Hirai; Kanichiro Wada; Keiichi Katsumi; Masao Koda; Atsushi Kimura; Takeo Furuya; Satoshi Maki; Narihito Nagoshi; Norihiro Nishida; Yukitaka Nagamoto; Yasushi Oshima; Kei Ando; Hiroaki Nakashima; Masahiko Takahata; Kanji Mori; Hideaki Nakajima; Kazuma Murata; Masayuki Miyagi; Takashi Kaito; Kei Yamada; Tomohiro Banno; Satoshi Kato; Tetsuro Ohba; Hiroshi Moridaira; Shunsuke Fujibayashi; Hiroyuki Katoh; Haruo Kanno; Hiroshi Taneichi; Shiro Imagama; Yoshiharu Kawaguchi; Katsushi Takeshita; Masaya Nakamura; Morio Matsumoto; Masashi Yamazaki; Atsushi Okawa; Toshitaka Yoshii

doi:10.1097/BRS.0000000000004762

Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures after Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament

Yu Matsukura, Satoru Egawa, Hiroyuki Inose, Kenichiro Sakai, Kazuo Kusano, Shunji Tsutsui, Takashi Hirai, Kanichiro Wada, Keiichi Katsumi, Masao Koda, Atsushi Kimura, Takeo Furuya, Satoshi Maki, Narihito Nagoshi, Norihiro Nishida, Yukitaka Nagamoto, Yasushi Oshima, Kei Ando, Hiroaki Nakashima, Masahiko TakahataKanji Mori, Hideaki Nakajima, Kazuma Murata, Masayuki Miyagi, Takashi Kaito, Kei Yamada, Tomohiro Banno, Satoshi Kato, Tetsuro Ohba, Hiroshi Moridaira, Shunsuke Fujibayashi, Hiroyuki Katoh, Haruo Kanno, Hiroshi Taneichi, Shiro Imagama, Yoshiharu Kawaguchi, Katsushi Takeshita, Masaya Nakamura, Morio Matsumoto, Masashi Yamazaki, Atsushi Okawa, Toshitaka Yoshii^*

^*Corresponding author for this work

Orthopaedic Surgery

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Study Design: A prospective multicenter study. Objective: To investigate the effect of preoperative symptom duration on neurological recovery for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data: The optimal timing to perform surgery in the setting of cervical OPLL remains unknown. It is important to know the influence of symptom duration on postoperative outcomes to facilitate discussions regarding the timing of surgery. Patients and Methods: The study included 395 patients (291 men and 104 women; mean age, 63.7 ± 11.4 yr): 204 were treated with laminoplasty, 90 with posterior decompression and fusion, 85 with anterior decompression and fusion, and 16 with other procedures. The Japanese Orthopedic Association (JOA) score and patient-reported outcomes of the JOA Cervical Myelopathy Evaluation Questionnaire were used to assess clinical outcomes preoperatively and 2 years after surgery. Logistic regression analysis was used to identify factors associated with the achievement of minimum clinically important difference (MCID) after surgery. Results: The recovery rate was significantly lower in the group with symptom duration of ≥5 years compared with the groups with durations of <0.5 years, 0.5 to 1 year, and 1 to 2 years. Improvement of JOA Cervical Myelopathy Evaluation Questionnaire in the upper extremity function score (P < 0.001), lower extremity function (P = 0.039), quality of life (P = 0.053), and bladder function (P = 0.034) were all decreased when the symptom duration exceeded 2 years. Duration of symptoms (P = 0.001), age (P < 0.001), and body mass index (P < 0.001) were significantly associated with the achievement of MCID. The cutoff value we established for symptom duration was 23 months (area under the curve, 0.616; sensitivity, 67.4%; specificity, 53.5%). Conclusions: Symptom duration had a significant impact on neurological recovery and patient-reported outcome measures in this series of patients undergoing surgery for cervical OPLL. Patients with symptom duration exceeding 23 months may be at greater risk of failing to achieve MCID after surgery. Level of Evidence. 3.

Original language	English
Pages (from-to)	1259-1265
Number of pages	7
Journal	Spine
Volume	48
Issue number	18
DOIs	https://doi.org/10.1097/BRS.0000000000004762
State	Published - 2023/09/15

Keywords

JOA score
JOACMEQ
MCID
OPLL
clinical outcome
symptom duration
timing for surgery

ASJC Scopus subject areas

Orthopedics and Sports Medicine
Clinical Neurology

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10.1097/BRS.0000000000004762

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Matsukura, Y., Egawa, S., Inose, H., Sakai, K., Kusano, K., Tsutsui, S., Hirai, T., Wada, K., Katsumi, K., Koda, M., Kimura, A., Furuya, T., Maki, S., Nagoshi, N., Nishida, N., Nagamoto, Y., Oshima, Y., Ando, K., Nakashima, H., ... Yoshii, T. (2023). Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures after Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament. Spine, 48(18), 1259-1265. https://doi.org/10.1097/BRS.0000000000004762

@article{11b5e5e61cac400e8839311303dce3f7,

title = "Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures after Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament",

abstract = "Study Design: A prospective multicenter study. Objective: To investigate the effect of preoperative symptom duration on neurological recovery for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data: The optimal timing to perform surgery in the setting of cervical OPLL remains unknown. It is important to know the influence of symptom duration on postoperative outcomes to facilitate discussions regarding the timing of surgery. Patients and Methods: The study included 395 patients (291 men and 104 women; mean age, 63.7 ± 11.4 yr): 204 were treated with laminoplasty, 90 with posterior decompression and fusion, 85 with anterior decompression and fusion, and 16 with other procedures. The Japanese Orthopedic Association (JOA) score and patient-reported outcomes of the JOA Cervical Myelopathy Evaluation Questionnaire were used to assess clinical outcomes preoperatively and 2 years after surgery. Logistic regression analysis was used to identify factors associated with the achievement of minimum clinically important difference (MCID) after surgery. Results: The recovery rate was significantly lower in the group with symptom duration of ≥5 years compared with the groups with durations of <0.5 years, 0.5 to 1 year, and 1 to 2 years. Improvement of JOA Cervical Myelopathy Evaluation Questionnaire in the upper extremity function score (P < 0.001), lower extremity function (P = 0.039), quality of life (P = 0.053), and bladder function (P = 0.034) were all decreased when the symptom duration exceeded 2 years. Duration of symptoms (P = 0.001), age (P < 0.001), and body mass index (P < 0.001) were significantly associated with the achievement of MCID. The cutoff value we established for symptom duration was 23 months (area under the curve, 0.616; sensitivity, 67.4%; specificity, 53.5%). Conclusions: Symptom duration had a significant impact on neurological recovery and patient-reported outcome measures in this series of patients undergoing surgery for cervical OPLL. Patients with symptom duration exceeding 23 months may be at greater risk of failing to achieve MCID after surgery. Level of Evidence. 3.",

keywords = "JOA score, JOACMEQ, MCID, OPLL, clinical outcome, symptom duration, timing for surgery",

author = "Yu Matsukura and Satoru Egawa and Hiroyuki Inose and Kenichiro Sakai and Kazuo Kusano and Shunji Tsutsui and Takashi Hirai and Kanichiro Wada and Keiichi Katsumi and Masao Koda and Atsushi Kimura and Takeo Furuya and Satoshi Maki and Narihito Nagoshi and Norihiro Nishida and Yukitaka Nagamoto and Yasushi Oshima and Kei Ando and Hiroaki Nakashima and Masahiko Takahata and Kanji Mori and Hideaki Nakajima and Kazuma Murata and Masayuki Miyagi and Takashi Kaito and Kei Yamada and Tomohiro Banno and Satoshi Kato and Tetsuro Ohba and Hiroshi Moridaira and Shunsuke Fujibayashi and Hiroyuki Katoh and Haruo Kanno and Hiroshi Taneichi and Shiro Imagama and Yoshiharu Kawaguchi and Katsushi Takeshita and Masaya Nakamura and Morio Matsumoto and Masashi Yamazaki and Atsushi Okawa and Toshitaka Yoshii",

year = "2023",

month = sep,

day = "15",

doi = "10.1097/BRS.0000000000004762",

language = "英語",

volume = "48",

pages = "1259--1265",

journal = "Spine",

issn = "0362-2436",

publisher = "Wolters Kluwer Health",

number = "18",

}

Matsukura, Y, Egawa, S, Inose, H, Sakai, K, Kusano, K, Tsutsui, S, Hirai, T, Wada, K, Katsumi, K, Koda, M, Kimura, A, Furuya, T, Maki, S, Nagoshi, N, Nishida, N, Nagamoto, Y, Oshima, Y, Ando, K, Nakashima, H, Takahata, M, Mori, K, Nakajima, H, Murata, K, Miyagi, M, Kaito, T, Yamada, K, Banno, T, Kato, S, Ohba, T, Moridaira, H, Fujibayashi, S, Katoh, H, Kanno, H, Taneichi, H, Imagama, S, Kawaguchi, Y, Takeshita, K, Nakamura, M, Matsumoto, M, Yamazaki, M, Okawa, A & Yoshii, T 2023, 'Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures after Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament', Spine, vol. 48, no. 18, pp. 1259-1265. https://doi.org/10.1097/BRS.0000000000004762

TY - JOUR

T1 - Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures after Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament

AU - Matsukura, Yu

AU - Egawa, Satoru

AU - Inose, Hiroyuki

AU - Sakai, Kenichiro

AU - Kusano, Kazuo

AU - Tsutsui, Shunji

AU - Hirai, Takashi

AU - Wada, Kanichiro

AU - Katsumi, Keiichi

AU - Koda, Masao

AU - Kimura, Atsushi

AU - Furuya, Takeo

AU - Maki, Satoshi

AU - Nagoshi, Narihito

AU - Nishida, Norihiro

AU - Nagamoto, Yukitaka

AU - Oshima, Yasushi

AU - Ando, Kei

AU - Nakashima, Hiroaki

AU - Takahata, Masahiko

AU - Mori, Kanji

AU - Nakajima, Hideaki

AU - Murata, Kazuma

AU - Miyagi, Masayuki

AU - Kaito, Takashi

AU - Yamada, Kei

AU - Banno, Tomohiro

AU - Kato, Satoshi

AU - Ohba, Tetsuro

AU - Moridaira, Hiroshi

AU - Fujibayashi, Shunsuke

AU - Katoh, Hiroyuki

AU - Kanno, Haruo

AU - Taneichi, Hiroshi

AU - Imagama, Shiro

AU - Kawaguchi, Yoshiharu

AU - Takeshita, Katsushi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Yamazaki, Masashi

AU - Okawa, Atsushi

AU - Yoshii, Toshitaka

PY - 2023/9/15

Y1 - 2023/9/15

N2 - Study Design: A prospective multicenter study. Objective: To investigate the effect of preoperative symptom duration on neurological recovery for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data: The optimal timing to perform surgery in the setting of cervical OPLL remains unknown. It is important to know the influence of symptom duration on postoperative outcomes to facilitate discussions regarding the timing of surgery. Patients and Methods: The study included 395 patients (291 men and 104 women; mean age, 63.7 ± 11.4 yr): 204 were treated with laminoplasty, 90 with posterior decompression and fusion, 85 with anterior decompression and fusion, and 16 with other procedures. The Japanese Orthopedic Association (JOA) score and patient-reported outcomes of the JOA Cervical Myelopathy Evaluation Questionnaire were used to assess clinical outcomes preoperatively and 2 years after surgery. Logistic regression analysis was used to identify factors associated with the achievement of minimum clinically important difference (MCID) after surgery. Results: The recovery rate was significantly lower in the group with symptom duration of ≥5 years compared with the groups with durations of <0.5 years, 0.5 to 1 year, and 1 to 2 years. Improvement of JOA Cervical Myelopathy Evaluation Questionnaire in the upper extremity function score (P < 0.001), lower extremity function (P = 0.039), quality of life (P = 0.053), and bladder function (P = 0.034) were all decreased when the symptom duration exceeded 2 years. Duration of symptoms (P = 0.001), age (P < 0.001), and body mass index (P < 0.001) were significantly associated with the achievement of MCID. The cutoff value we established for symptom duration was 23 months (area under the curve, 0.616; sensitivity, 67.4%; specificity, 53.5%). Conclusions: Symptom duration had a significant impact on neurological recovery and patient-reported outcome measures in this series of patients undergoing surgery for cervical OPLL. Patients with symptom duration exceeding 23 months may be at greater risk of failing to achieve MCID after surgery. Level of Evidence. 3.

AB - Study Design: A prospective multicenter study. Objective: To investigate the effect of preoperative symptom duration on neurological recovery for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL). Summary of Background Data: The optimal timing to perform surgery in the setting of cervical OPLL remains unknown. It is important to know the influence of symptom duration on postoperative outcomes to facilitate discussions regarding the timing of surgery. Patients and Methods: The study included 395 patients (291 men and 104 women; mean age, 63.7 ± 11.4 yr): 204 were treated with laminoplasty, 90 with posterior decompression and fusion, 85 with anterior decompression and fusion, and 16 with other procedures. The Japanese Orthopedic Association (JOA) score and patient-reported outcomes of the JOA Cervical Myelopathy Evaluation Questionnaire were used to assess clinical outcomes preoperatively and 2 years after surgery. Logistic regression analysis was used to identify factors associated with the achievement of minimum clinically important difference (MCID) after surgery. Results: The recovery rate was significantly lower in the group with symptom duration of ≥5 years compared with the groups with durations of <0.5 years, 0.5 to 1 year, and 1 to 2 years. Improvement of JOA Cervical Myelopathy Evaluation Questionnaire in the upper extremity function score (P < 0.001), lower extremity function (P = 0.039), quality of life (P = 0.053), and bladder function (P = 0.034) were all decreased when the symptom duration exceeded 2 years. Duration of symptoms (P = 0.001), age (P < 0.001), and body mass index (P < 0.001) were significantly associated with the achievement of MCID. The cutoff value we established for symptom duration was 23 months (area under the curve, 0.616; sensitivity, 67.4%; specificity, 53.5%). Conclusions: Symptom duration had a significant impact on neurological recovery and patient-reported outcome measures in this series of patients undergoing surgery for cervical OPLL. Patients with symptom duration exceeding 23 months may be at greater risk of failing to achieve MCID after surgery. Level of Evidence. 3.

KW - JOA score

KW - JOACMEQ

KW - MCID

KW - OPLL

KW - clinical outcome

KW - symptom duration

KW - timing for surgery

UR - http://www.scopus.com/inward/record.url?scp=85168805338&partnerID=8YFLogxK

U2 - 10.1097/BRS.0000000000004762

DO - 10.1097/BRS.0000000000004762

M3 - 学術論文

C2 - 37368973

AN - SCOPUS:85168805338

SN - 0362-2436

VL - 48

SP - 1259

EP - 1265

JO - Spine

JF - Spine

IS - 18

ER -

Preoperative Symptom Duration Influences Neurological Recovery and Patient-Reported Outcome Measures after Surgical Treatment of Cervical Ossification of the Posterior Longitudinal Ligament

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Keywords

ASJC Scopus subject areas

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