• Narihito Nagoshi, Toshitaka Yoshii, Satoru Egawa, Kenichiro Sakai, Kazuo Kusano, Shunji Tsutsui, Takashi Hirai, Yu Matsukura, Kanichiro Wada, Keiichi Katsumi, Masao Koda, Atsushi Kimura, Takeo Furuya, Satoshi Maki, Norihiro Nishida, Yukitaka Nagamoto, Yasushi Oshima, Kei Ando, Hiroaki Nakashima, Masahiko Takahata, Kanji Mori, Hideaki Nakajima, Kazuma Murata, Masayuki Miyagi, Takashi Kaito, Kei Yamada, Tomohiro Banno, Satoshi Kato, Tetsuro Ohba, Satoshi Inami, Shunsuke Fujibayashi, Hiroyuki Katoh, Haruo Kanno, Kota Watanabe, Hiroshi Taneichi, Shiro Imagama, Yoshiharu Kawaguchi, Katsushi Takeshita, Masaya Nakamura, Morio Matsumoto, Masashi Yamazaki, and Atsushi Okawa.
• Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
• Spine. 2022 Aug 1; 47 (15): 107710831077-1083.

Study DesignA prospective multicenter study.ObjectiveThis study aims to evaluate patient-reported outcomes using the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and clarify clinical factors that affect the therapeutic effects for patients with cervical ossification of the posterior longitudinal ligament (OPLL).Summary Of Background DataAlthough previous studies identified factors that affected the surgical outcomes, their assessment was mainly based on the Japanese Orthopedic Association score, which only includes neurological function. Investigating this pathology through multiple functions and quality of life (QOL) is pivotal to understanding the comprehensive clinical pictures of the cervical OPLL and its therapeutic outcomes.Materials And MethodsThis study was performed by the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament. A total of 478 patients with myelopathy caused by cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for 2 years. Of the patients, 168 received laminoplasties and fully completed questionnaires. Demographic information, imaging findings, and clinical outcomes were collected. Patients were grouped according to effective or ineffective surgical outcomes as defined by the JOACMEQ using logistic regression analyses.ResultsLaminoplasty resulted in functional improvement in the cervical spine and upper extremity around 40% of the patients, while QOL showed only 21.4% ( P <0.01). Multivariable analyses revealed that younger age and a postoperative decrease in arm or hand pain were correlated with significantly improved function of the upper extremities. A reduction in lower limb pain favorably affected the postoperative lower extremity function. A postoperative reduction in upper extremity pain enhanced the QOL recovery.ConclusionsSurgeons should recognize the diversity of surgical outcomes after laminoplasty and understand the necessity of pain management even after the surgery to enhance bodily functions and QOL in patients with cervical OPLL.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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