Comparison of Reoperation Incidence After Anterior Versus Posterior Decompression and Fusion for Cervical Ossification of the Posterior Longitudinal Ligament: Analysis of a Large Claims-based Database.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-07-11 DOI:10.1097/BSD.0000000000001876

Soichiro Masuda, Toshiki Fukasawa, Bungo Otsuki, Koichi Murata, Takayoshi Shimizu, Takashi Sono, Shintaro Honda, Koichiro Shima, Masaki Sakamoto, Shuichi Matsuda, Koji Kawakami

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引用次数: 0

Abstract

Study design: Cohort study.

Objective: To compare reoperation rates between anterior decompression and fusion (ADF) and posterior decompression and fusion (PDF) in patients with cervical ossification of the posterior longitudinal ligament (OPLL).

Summary of background data: Reoperation after cervical OPLL surgery is a significant concern for both patients and surgeons. It is unclear which surgical approach, ADF or PDF, is superior in terms of reoperation rates for cervical OPLL.

Methods: This study was conducted under a cohort design in patients who underwent ADF or PDF for cervical OPLL using claims-based data. Primary outcome was the incidence of reoperation during the follow-up period, and secondary outcome was total health care costs during hospitalization, and at 30 days and 1 year postoperatively. Confounding factors were adjusted using propensity score inverse probability of treatment weighting. Cumulative incidence of reoperation was calculated using the Kaplan-Meier method. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression models.

Results: The study included 251 patients (123 patients in the ADF group and 128 in the PDF group). There was no significant difference in the incidence of reoperation between the 2 groups [weighted HR 2.00 (95% CI 0.76-5.25); P=0.16]. ADF was associated with lower mean costs than PDF during hospitalization [$6416 (95% CI $4898-$7,934); P <0.001], and at 30 days [$6449 (95% CI $4942-$7956)] and 1 year postoperatively [$10,268 ($6545-$13,992); P <0.001].

Conclusions: Although reoperation rates for ADF and PDF in patients with cervical OPLL were similar, ADF was associated with lower health care costs. This study provides important information that will help surgeons make informed decisions about the choice of surgical approach for patients with cervical OPLL.

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颈椎后纵韧带骨化前后路减压融合术再手术发生率比较：基于大型索赔数据库的分析

研究设计：队列研究。目的：比较前路减压融合术（ADF）与后路减压融合术（PDF）治疗颈椎后纵韧带骨化症（OPLL）的再手术率。背景资料总结：颈椎OPLL手术后的再手术是患者和外科医生都非常关注的问题。目前尚不清楚哪一种手术入路（ADF或PDF）在颈椎OPLL的再手术率方面更优越。方法：本研究采用基于索赔的数据，在接受ADF或PDF治疗颈椎OPLL的患者中进行队列设计。主要观察指标为随访期间的再手术发生率，次要观察指标为住院期间、术后30天和1年的总医疗费用。使用倾向得分反概率治疗加权调整混杂因素。用Kaplan-Meier法计算累计再手术发生率。使用Cox比例风险回归模型估计风险比（hr）和95% ci。结果：共纳入251例患者（ADF组123例，PDF组128例）。两组再手术发生率无显著差异[加权危险度2.00 (95% CI 0.76-5.25)；P = 0.16)。住院期间ADF的平均费用低于PDF[6416美元（95% CI $4898- 7,934美元）；结论：尽管宫颈OPLL患者ADF和PDF的再手术率相似，但ADF与较低的医疗费用相关。这项研究提供了重要的信息，将有助于外科医生做出明智的决定，选择手术入路，为患者颈椎OPLL。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.