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Factors Associated With Repeat Surgery in Cervical Ossification of the Posterior Longitudinal Ligaments: Minimum
Hyun Jun Jang1, Bong Ju Moon1, Kyung Hyun Kim1
1Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul.
Study Design:
Single-center retrospective study.
Objective:
The objective of this study is to identify the factors leading to repeat surgery in patients with cervical ossification of the longitudinal ligament (OPLL) during a minimal 8-year follow-up after the initial surgery.
Summary Of Background Data:
The long-term effects of cervical OPLL are well known, but it's not always clear how many patients need to have surgery again because their neurological symptoms get worse.
Methods:
This study is included 117 patients who underwent surgery for cervical OPLL and had a follow-up of at least 8 years. OPLL type, surgical extent, surgical method, and sagittal radiological parameters were measured, and OPLL characteristics were analyzed.
Results:
The average age of patients at the time of surgery was 53.2 years, with a male-to-female ratio of 78:39. The median follow-up duration was 122 months (96-170 mo). Out of the total, 20 cases (17.1%) necessitated repeat surgery, among which 8 cases required surgery at the same site as the initial operation. The highest rate of repeat surgery was observed in patients who underwent total laminectomy without fusion (TL), where 6 out of 21 patients (29%) needed a second surgery, and 5 of these (23%) involved the same surgical site. Patients who underwent repeat surgery at the same site exhibited a greater range of motion (ROM) one year postsurgery (16.4 ± 8.5° vs. 23.1 ± 12.7°, P =0.041). In addition, the ROM at 1 year was higher in patients who underwent TL compared with those who had laminoplasty. Furthermore, the recurrence rate for hill-shape OPLL was higher at 30.8% compared to 10% for plateau-shape OPLL ( P = 0.05).
Conclusion:
Larger cervical ROM 1 year after surgery is related to repeat surgery at the same level as previous surgery, especially in laminectomy without fusion surgery.
