The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis

Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between ante...
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Autor*in:	Dong Hwan Kim [verfasserIn] Chang-Hyun Lee [verfasserIn] Young San Ko [verfasserIn] Seung Heon Yang [verfasserIn] Chi Heon Kim [verfasserIn] Sung Bae Park [verfasserIn] Chun Kee Chung [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication

Übergeordnetes Werk:	In: Neurospine - Korean Spinal Neurosurgery Society, 2019, 16(2019), 3, Seite 530-541
Übergeordnetes Werk:	volume:16 ; year:2019 ; number:3 ; pages:530-541

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.14245/ns.1938326.163

Katalog-ID:	DOAJ078119537

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520			\|a Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL.
650		4	\|a Anterior decompression and fusion
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650		4	\|a Ossification of the posterior longitudinal ligament
650		4	\|a Recovery rate
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653		0	\|a Neurology. Diseases of the nervous system
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allfields	10.14245/ns.1938326.163 doi (DE-627)DOAJ078119537 (DE-599)DOAJefcdaec7504246459b25659191658674 DE-627 ger DE-627 rakwb eng RC346-429 Dong Hwan Kim verfasserin aut The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL. Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication Neurology. Diseases of the nervous system Chang-Hyun Lee verfasserin aut Young San Ko verfasserin aut Seung Heon Yang verfasserin aut Chi Heon Kim verfasserin aut Sung Bae Park verfasserin aut Chun Kee Chung verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 3, Seite 530-541 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:3 pages:530-541 https://doi.org/10.14245/ns.1938326.163 kostenfrei https://doaj.org/article/efcdaec7504246459b25659191658674 kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1938326-163.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 3 530-541
spelling	10.14245/ns.1938326.163 doi (DE-627)DOAJ078119537 (DE-599)DOAJefcdaec7504246459b25659191658674 DE-627 ger DE-627 rakwb eng RC346-429 Dong Hwan Kim verfasserin aut The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL. Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication Neurology. Diseases of the nervous system Chang-Hyun Lee verfasserin aut Young San Ko verfasserin aut Seung Heon Yang verfasserin aut Chi Heon Kim verfasserin aut Sung Bae Park verfasserin aut Chun Kee Chung verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 3, Seite 530-541 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:3 pages:530-541 https://doi.org/10.14245/ns.1938326.163 kostenfrei https://doaj.org/article/efcdaec7504246459b25659191658674 kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1938326-163.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 3 530-541
allfields_unstemmed	10.14245/ns.1938326.163 doi (DE-627)DOAJ078119537 (DE-599)DOAJefcdaec7504246459b25659191658674 DE-627 ger DE-627 rakwb eng RC346-429 Dong Hwan Kim verfasserin aut The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL. Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication Neurology. Diseases of the nervous system Chang-Hyun Lee verfasserin aut Young San Ko verfasserin aut Seung Heon Yang verfasserin aut Chi Heon Kim verfasserin aut Sung Bae Park verfasserin aut Chun Kee Chung verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 3, Seite 530-541 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:3 pages:530-541 https://doi.org/10.14245/ns.1938326.163 kostenfrei https://doaj.org/article/efcdaec7504246459b25659191658674 kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1938326-163.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 3 530-541
allfieldsGer	10.14245/ns.1938326.163 doi (DE-627)DOAJ078119537 (DE-599)DOAJefcdaec7504246459b25659191658674 DE-627 ger DE-627 rakwb eng RC346-429 Dong Hwan Kim verfasserin aut The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL. Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication Neurology. Diseases of the nervous system Chang-Hyun Lee verfasserin aut Young San Ko verfasserin aut Seung Heon Yang verfasserin aut Chi Heon Kim verfasserin aut Sung Bae Park verfasserin aut Chun Kee Chung verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 3, Seite 530-541 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:3 pages:530-541 https://doi.org/10.14245/ns.1938326.163 kostenfrei https://doaj.org/article/efcdaec7504246459b25659191658674 kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1938326-163.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 3 530-541
allfieldsSound	10.14245/ns.1938326.163 doi (DE-627)DOAJ078119537 (DE-599)DOAJefcdaec7504246459b25659191658674 DE-627 ger DE-627 rakwb eng RC346-429 Dong Hwan Kim verfasserin aut The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL. Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication Neurology. Diseases of the nervous system Chang-Hyun Lee verfasserin aut Young San Ko verfasserin aut Seung Heon Yang verfasserin aut Chi Heon Kim verfasserin aut Sung Bae Park verfasserin aut Chun Kee Chung verfasserin aut In Neurospine Korean Spinal Neurosurgery Society, 2019 16(2019), 3, Seite 530-541 (DE-627)1725218615 (DE-600)3031654-6 25866591 nnns volume:16 year:2019 number:3 pages:530-541 https://doi.org/10.14245/ns.1938326.163 kostenfrei https://doaj.org/article/efcdaec7504246459b25659191658674 kostenfrei http://www.e-neurospine.org/upload/pdf/ns-1938326-163.pdf kostenfrei https://doaj.org/toc/2586-6583 Journal toc kostenfrei https://doaj.org/toc/2586-6591 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2019 3 530-541
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source	In Neurospine 16(2019), 3, Seite 530-541 volume:16 year:2019 number:3 pages:530-541
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topic_facet	Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication Neurology. Diseases of the nervous system
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authorswithroles_txt_mv	Dong Hwan Kim @@aut@@ Chang-Hyun Lee @@aut@@ Young San Ko @@aut@@ Seung Heon Yang @@aut@@ Chi Heon Kim @@aut@@ Sung Bae Park @@aut@@ Chun Kee Chung @@aut@@
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author	Dong Hwan Kim
spellingShingle	Dong Hwan Kim misc RC346-429 misc Anterior decompression and fusion misc Laminoplasty misc Ossification of the posterior longitudinal ligament misc Recovery rate misc Complication misc Neurology. Diseases of the nervous system The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis
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topic_title	RC346-429 The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis Anterior decompression and fusion Laminoplasty Ossification of the posterior longitudinal ligament Recovery rate Complication
topic	misc RC346-429 misc Anterior decompression and fusion misc Laminoplasty misc Ossification of the posterior longitudinal ligament misc Recovery rate misc Complication misc Neurology. Diseases of the nervous system
topic_unstemmed	misc RC346-429 misc Anterior decompression and fusion misc Laminoplasty misc Ossification of the posterior longitudinal ligament misc Recovery rate misc Complication misc Neurology. Diseases of the nervous system
topic_browse	misc RC346-429 misc Anterior decompression and fusion misc Laminoplasty misc Ossification of the posterior longitudinal ligament misc Recovery rate misc Complication misc Neurology. Diseases of the nervous system
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title	The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis
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title_full	The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis
author_sort	Dong Hwan Kim
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author_browse	Dong Hwan Kim Chang-Hyun Lee Young San Ko Seung Heon Yang Chi Heon Kim Sung Bae Park Chun Kee Chung
container_volume	16
class	RC346-429
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author-letter	Dong Hwan Kim
doi_str_mv	10.14245/ns.1938326.163
author2-role	verfasserin
title_sort	clinical implications and complications of anterior versus posterior surgery for multilevel cervical ossification of the posterior longitudinal ligament; an updated systematic review and meta-analysis
callnumber	RC346-429
title_auth	The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis
abstract	Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL.
abstractGer	Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL.
abstract_unstemmed	Objective Theoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL. Methods We searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively. Results We included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID. Conclusion Anterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL.
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title_short	The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis
url	https://doi.org/10.14245/ns.1938326.163 https://doaj.org/article/efcdaec7504246459b25659191658674 http://www.e-neurospine.org/upload/pdf/ns-1938326-163.pdf https://doaj.org/toc/2586-6583 https://doaj.org/toc/2586-6591
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up_date	2024-07-03T16:03:51.494Z
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