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 International Study on 479 Patients
Notice bibliographique
Résumé
Introduction Degenerative cervical myelopathy (DCM) is an umbrella term that includes cervical spondylotic myelopathy, ossification of the posterior longitudinal ligament (OPLL) and other forms of degenerative changes to the spinal axis. The surgical management of OPLL can be technically challenging for spine surgeons and may result in a higher incidence of perioperative complications than surgery for other forms of DCM. It is unclear whether surgery is equally effective and safe in patients with OPLL as it is in other forms of DCM. This study aims to compare the impact of cervical decompressive surgery on functional status and Quality of Life (QOL) outcomes in patients with OPLL and those with other forms of DCM. Material and Methods 479 surgical patients with symptomatic DCM were prospectively enrolled in the CSM-International study at global 16 sites. Patients’ functional and neurological status were evaluated using the modified Japanese Orthopedic Assessment scale (mJOA) and the Nurick score. QOL was assessed using patient-reported outcome measures, including the Neck Disability Index (NDI) and the Short- Form 36 (SF-36) Health Survey. Improvements in functional status and QOL were assessed between baseline and 1- and 2-year follow-ups, and relative gains were compared between patients with and without OPLL. A sub-analysis was conducted in patients with “severe” myelopathy (a preoperative mJOA < 12) to determine whether surgical outcomes differed between patients with severe OPLL and those with other forms of severe DCM. Improvements in preoperative functional status and QOL at 2-years follow-up were compared between the two diagnosis groups, while controlling for relevant confounding variables. Results Of 479 patients, 135 (28.2%) exhibited evidence of OPLL and 344 (71.8%) displayed other forms of degenerative changes. There were no significant differences in demographics, surgical approach, or baseline severity scores between patients with OPLL and those with other forms of DCM. Patients with OPLL achieved similar functional outcomes at 1- and 2-years following surgery when compared with patients with other forms of DCM. With respect to QOL, the NDI and most subscales of the SF-36, there were no differences between the two diagnosis groups. However, the SF-36 Role Limitation Physical subscale ( p = 0.0091) at 1-year and the SF-36 Social Functioning subscale at 1- and 2-years ( p = 0.014, p = 0.018) were significantly lower in OPLL patients. In patients with severe myelopathy (preoperative mJOA < 12), 49 (28.65%) presented with OPLL and 122 (71.35%) with other forms of DCM. There were comparable improvements between preoperative and 2-year postoperative scores across all outcome measures (mJOA, Nurick, NDI, and SF-36) in patients with severe myelopathy due to OPLL and other forms of DCM. Finally, there was a significantly higher rate of perioperative complications in the OPLL group ( p = 0.054). This significant difference was mainly due to a higher incidence of superficial infection ( p = 0.0067), new neck pain ( p = 0.079) and dural tear ( p = 0.076) in the OPLL group. However, rates of neurological complication did not significantly differ ( p = 0.73). Conclusion 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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».