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Predictive factors for bladder function recovery following cervical OPLL surgery: a comprehensive analysis.

Yusuke Setojima1, Kengo Fujii2, Toru Funayama1

  • 1Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan.

The Spine Journal : Official Journal of the North American Spine Society
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Summary

Age and preoperative Japanese Orthopaedic Association (JOA) scores for lower extremity motor and trunk sensory function predict bladder recovery after cervical ossification of posterior longitudinal ligaments (OPLL) surgery.

Keywords:
Bladder function recoveryCervical OPLL surgeryJOA scoreNeurogenic bladder dysfunctionOPLLPrediction modelPredictive factor

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Urology

Background:

  • Cervical ossification of posterior longitudinal ligaments (OPLL) frequently causes neurogenic bladder dysfunction.
  • Predicting postoperative bladder function is vital for patient management but lacks validated models.
  • The Japanese Orthopaedic Association (JOA) score assesses various neurological functions.

Purpose of the Study:

  • To identify preoperative predictors of bladder function recovery 1 year after surgery in cervical OPLL patients.
  • To determine the correlation between postoperative bladder outcomes and preoperative parameters, including the JOA score.

Main Methods:

  • Retrospective analysis of prospectively collected data from 192 cervical OPLL patients.
  • Utilized univariable and multivariable Cox proportional hazards regression models.
  • Examined preoperative variables including age, sex, BMI, comorbidities, JOA score, OPLL occupation ratio, K-line, surgical approach, spinal fusion, and vertebral levels.

Main Results:

  • Age, preoperative JOA lower extremity motor function score, and JOA trunk sensory function score were significant predictors of bladder function recovery.
  • Optimal thresholds for predicting complete recovery were identified as 1.5 points for both JOA lower extremity motor and trunk sensory function scores.

Conclusions:

  • Age and specific JOA subscores (lower extremity motor and trunk sensory function) are key predictors of bladder function recovery post-cervical OPLL surgery.
  • These factors can inform the development of a predictive model for clinical decision-making and patient counseling.