Highlights
- •Perioperative factors associated with favorable outcomes of PDF for cervical OPLL.
- •OPLL patients with preoperative lordotic alignment can have favorable outcomes.
- •It is important to maintain the cervical lordotic alignment postoperatively.
Abstract
Purpose
Posterior decompression with instrumented fusion (PDF) is a suitable surgical treatment
for K-line (−)-type cervical ossification of the posterior longitudinal ligament (OPLL).
However, the adequate indications of PDF have not been clarified yet. The purpose
of this study was to investigate the surgical results of PDF and perioperative factors
that influence the surgical outcome, and to clarify the adequate indications of PDF.
Methods
Twenty-seven patients (21 men and 6 women, mean age: 61.4 years) who were diagnosed
with a K-line (−)-type OPLL that was treated with PDF were included in this study.
We evaluated these patients clinically and radiologically to investigate the outcomes
of PDF and perioperative factors that influence improvements in the Japanese Orthopedic
Association (JOA) score.
Results
The mean recovery rate of JOA score at the final follow-up examination was 53.3%.
In the statistical analysis, the preoperative C2-C7 angle and the C2-C7 angle immediately
postoperatively significantly predicted the surgical outcome. The C2-C7 angle immediately
postoperatively was the only most important predictor. Using a receiver operating
characteristic curve analysis, we found that the cutoff value of the C2-C7 angle immediately
postoperatively for good outcomes (recovery rate of JOA score ≥50%) was −2.0°.
Conclusions
PDF for K-line (−)-type OPLL patients with preoperative lordotic alignment can be
expected to have favorable outcomes, which is the adequate indication for PDF. Since
the C2-C7 angle immediately postoperatively was the most important predictor, the
physician should pay attention to maintain the cervical lordotic alignment to enhance
the surgical outcomes in surgical planning.
Keywords
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Article info
Publication history
Published online: August 23, 2018
Accepted:
August 13,
2018
Received:
April 28,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
