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  • Quality of Life and Functional Outcomes after Surgical Decompression in Patients with Cervical Ossification of the Posterior Longitudinal Ligament: Results from the Prospective, Multicenter AOSpine In

    Final Number:
    686

    Authors:
    H. Nakashima, L. Tetreault, N. Nagoshi, A. Nouri, M.G. Fehlings

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: It is unclear whether surgery is equally effective and safe in patients with ossification of the posterior longitudinal ligament (OPLL) as it is in other forms of degenerative cervical myelopathy (DCM). This study aims to compare surgical outcomes between OPLL patients and those with other forms of DCM.

    Methods: 479 surgical patients with DCM were prospectively enrolled. Patient neurological status was evaluated using the mJOA and the Nurick score. Quality of Life (QOL) was assessed using the Neck Disability Index (NDI) and the SF-36 Health Survey. Improvements in functional status and QOL were assessed between baseline and 1-year follow-up, and relative gains were compared between patients with and without OPLL.

    Results: 135 (28.2%) participants exhibited image evidence of OPLL. There were no significant differences in demographics, surgical approach, or baseline severity scores between OPLL patients and those with other forms of DCM. OPLL patients achieved similar neurological outcomes at 1-year following surgery when compared to patients with other forms of DCM. With respect to QOL, there were no differences between the groups. However, the SF-36 Role Limitation Physical subscale (p=0.0091) and the SF-36 Social Functioning subscale (p=0.014) scores were significantly lower in OPLL patients. Finally, there was a significantly higher rate of perioperative complications in the OPLL group (p=0.054) although rates of neurological complications did not significantly differ.

    Conclusions: Surgical decompression for the treatment of OPLL results in significant improvements in functional status and QOL comparable to gains seen in other forms of DCM.

    Patient Care: This study aims to compare surgical outcomes between OPLL patients and those with other forms of DCM.

    Learning Objectives: To compare surgical outcomes between OPLL patients and those with other forms of DCM.

    References:

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