TY - JOUR
T1 - Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament
AU - Miyagi, Masayuki
AU - Inoue, Gen
AU - Yoshii, Toshitaka
AU - Egawa, Satoru
AU - Sakai, Kenichiro
AU - Kusano, Kazuo
AU - Nakagawa, Yukihiro
AU - Hirai, Takashi
AU - Wada, Kanichiro
AU - Katsumi, Keiichi
AU - Kimura, Atsushi
AU - Furuya, Takeo
AU - Nagoshi, Narihito
AU - Kanchiku, Tsukasa
AU - Nagamoto, Yukitaka
AU - Oshima, Yasushi
AU - Nakashima, Hiroaki
AU - Ando, Kei
AU - Takahata, Masahiko
AU - Mori, Kanji
AU - Nakajima, Hideaki
AU - Murata, Kazuma
AU - Matsunaga, Shunji
AU - Kaito, Takashi
AU - Yamada, Kei
AU - Kobayashi, Sho
AU - Kato, Satoshi
AU - Ohba, Tetsuro
AU - Inami, Satoshi
AU - Fujibayashi, Shunsuke
AU - Katoh, Hiroyuki
AU - Kanno, Haruo
AU - Koda, Masao
AU - Takahashi, Hiroshi
AU - Ikeda, Shinsuke
AU - Imagama, Shiro
AU - Kawaguchi, Yoshiharu
AU - Takeshita, Katsushi
AU - Matsumoto, Morio
AU - Takaso, Masashi
AU - Okawa, Atsushi
AU - Yamazaki, Masashi
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Study Design: A prospective multi-institutional observational study. Objective: To investigate and identify risk factors for residual neuropathic pain after surgery in patients with cervical ossification of posterior longitudinal ligament (c-OPLL). Summary of Background Data: Patients with c-OPLL often require surgery for numbness and paralysis of the extremities; however, postoperative neuropathic pain can considerably deteriorate their quality of life. Methods: Out of 479 patients identified from multicenter c-OPLL registries between 2014 and 2017, 292 patients who could be followed up for 2 years postoperatively were reviewed, after excluding patients with nervous system comorbidities. Demographic details; medical history; radiographic factors including the K-line, spinal canal occupancy rate of OPLL, cervical kyphosis angle, and presence of spinal cord myelomalacia; preoperative Japanese Orthopaedic Association (JOA) score; surgical procedure (fusion or decompression surgery); postoperative neurological deterioration; and the visual analogue scale for pain and numbness in the upper extremities (U/E) or trunk/lower extremities (L/E) at baseline and at 2 years postoperatively were assessed. Patients were grouped into residual and non-residual groups based on a postoperative visual analogue scale ≥40 mm. Risk factors for residual neuropathic pain were evaluated by multiple logistic regression analysis. Results: The prevalence of U/E and L/E residual pain in postoperative c-OPLL patients was 51.7% and 40.4%, respectively. The U/E residual group had a poor preoperative JOA score and longer illness duration, and fusion surgery was more common in the residual group than in non-residual group. The L/E residual group was older with a poorer preoperative JOA score. On multivariate analysis, risk factors for U/E residual pain were long illness duration and poor preoperative JOA score, whereas those for L/E residual pain were age and poor preoperative JOA score. Conclusions: The risk factors for residual spinal neuropathic pain after c-OPLL surgery were age, long duration of illness, and poor preoperative JOA score. Level of Evidence: IV.
AB - Study Design: A prospective multi-institutional observational study. Objective: To investigate and identify risk factors for residual neuropathic pain after surgery in patients with cervical ossification of posterior longitudinal ligament (c-OPLL). Summary of Background Data: Patients with c-OPLL often require surgery for numbness and paralysis of the extremities; however, postoperative neuropathic pain can considerably deteriorate their quality of life. Methods: Out of 479 patients identified from multicenter c-OPLL registries between 2014 and 2017, 292 patients who could be followed up for 2 years postoperatively were reviewed, after excluding patients with nervous system comorbidities. Demographic details; medical history; radiographic factors including the K-line, spinal canal occupancy rate of OPLL, cervical kyphosis angle, and presence of spinal cord myelomalacia; preoperative Japanese Orthopaedic Association (JOA) score; surgical procedure (fusion or decompression surgery); postoperative neurological deterioration; and the visual analogue scale for pain and numbness in the upper extremities (U/E) or trunk/lower extremities (L/E) at baseline and at 2 years postoperatively were assessed. Patients were grouped into residual and non-residual groups based on a postoperative visual analogue scale ≥40 mm. Risk factors for residual neuropathic pain were evaluated by multiple logistic regression analysis. Results: The prevalence of U/E and L/E residual pain in postoperative c-OPLL patients was 51.7% and 40.4%, respectively. The U/E residual group had a poor preoperative JOA score and longer illness duration, and fusion surgery was more common in the residual group than in non-residual group. The L/E residual group was older with a poorer preoperative JOA score. On multivariate analysis, risk factors for U/E residual pain were long illness duration and poor preoperative JOA score, whereas those for L/E residual pain were age and poor preoperative JOA score. Conclusions: The risk factors for residual spinal neuropathic pain after c-OPLL surgery were age, long duration of illness, and poor preoperative JOA score. Level of Evidence: IV.
KW - cervical ossification of posterior longitudinal ligament
KW - japanese orthopaedic association score
KW - postoperative neuropathic pain
KW - residual pain
KW - risk factors
KW - visual analogue scale
UR - http://www.scopus.com/inward/record.url?scp=85164047725&partnerID=8YFLogxK
U2 - 10.1097/BSD.0000000000001449
DO - 10.1097/BSD.0000000000001449
M3 - 学術論文
C2 - 36823706
AN - SCOPUS:85164047725
SN - 2380-0186
VL - 36
SP - E277-E282
JO - Clinical Spine Surgery
JF - Clinical Spine Surgery
IS - 6
ER -