{"title":"高龄是否会对颈椎后纵韧带骨化的治疗结果产生负面影响？一项前瞻性多中心研究。","authors":"Narihito Nagoshi, 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, Tsutomu Endo, Kanji Mori, Hideaki Nakajima, Kazuma Murata, Masayuki Miyagi, Takashi Kaito, Kei Yamada, Tomohiro Banno, Satoshi Kato, Tetsuro Ohba, Masahiko Takahata, Hiroshi Moridaira, Shunsuke Fujibayashi, Hiroyuki Katoh, Haruo Kanno, Kota Watanabe, Hiroshi Taneichi, Shiro Imagama, Yoshiharu Kawaguchi, Katsushi Takeshita, Masaya Nakamura, Morio Matsumoto, Masashi Yamazaki, Toshitaka Yoshii","doi":"10.1097/BRS.0000000000005415","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>A multicenter prospective cohort study.</p><p><strong>Objective: </strong>To comprehensively evaluate the surgical impact, including patient-reported outcomes (PROs), in elderly patients with cervical ossification of the posterior longitudinal ligament (OPLL).</p><p><strong>Summary of background data: </strong>With the rise of aging populations worldwide, understanding the impact of age on treatment outcomes for cervical OPLL has become increasingly important. Previous studies on degenerative cervical myelopathy have highlighted inconsistent outcomes for elderly patients, with limited focus on OPLL and PROs.</p><p><strong>Methods: </strong>This prospective, multi-institutional study included 402 cervical OPLL patients from 2014 to 2017, categorized into elderly (≥75 y, n=79) and non-elderly (<75 y, n=323) groups. Clinical outcomes were assessed preoperatively and two years postoperatively using cervical Japanese Orthopedic Association (JOA) scores, visual analog scale (VAS) scores, and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). Multivariable regression analyses were conducted, adjusting for potential confounders, including demographic variables and imaging characteristics.</p><p><strong>Results: </strong>Elderly patients had worse preoperative JOA scores (9.6 vs. 11.1, P<0.01) and lower postoperative scores at two years (12.3 vs. 14.0, P<0.01). However, the improvement in JOA scores was comparable (2.7 vs. 3.0, P=0.48), with both exceeding the minimum clinically important difference (MCID). Complication rates and VAS score improvements were also comparable. JOACMEQ outcomes demonstrated significantly poorer upper extremity function in the elderly group following surgery (P=0.02), whereas no significant differences were observed between the two groups in other functional domains.</p><p><strong>Conclusion: </strong>Despite worse baseline neurological function, elderly OPLL patients achieved similar degrees of postoperative neurological improvement as non-elderly patients. However, upper extremity function is unlikely to show significant improvement following surgery in elderly patients.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does Advanced Age Negatively Impact Treatment Outcomes of Cervical Ossification of the Posterior Longitudinal Ligament? A Prospective Multicenter Study.\",\"authors\":\"Narihito Nagoshi, 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, Tsutomu Endo, Kanji Mori, Hideaki Nakajima, Kazuma Murata, Masayuki Miyagi, Takashi Kaito, Kei Yamada, Tomohiro Banno, Satoshi Kato, Tetsuro Ohba, Masahiko Takahata, Hiroshi Moridaira, Shunsuke Fujibayashi, Hiroyuki Katoh, Haruo Kanno, Kota Watanabe, Hiroshi Taneichi, Shiro Imagama, Yoshiharu Kawaguchi, Katsushi Takeshita, Masaya Nakamura, Morio Matsumoto, Masashi Yamazaki, Toshitaka Yoshii\",\"doi\":\"10.1097/BRS.0000000000005415\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>A multicenter prospective cohort study.</p><p><strong>Objective: </strong>To comprehensively evaluate the surgical impact, including patient-reported outcomes (PROs), in elderly patients with cervical ossification of the posterior longitudinal ligament (OPLL).</p><p><strong>Summary of background data: </strong>With the rise of aging populations worldwide, understanding the impact of age on treatment outcomes for cervical OPLL has become increasingly important. Previous studies on degenerative cervical myelopathy have highlighted inconsistent outcomes for elderly patients, with limited focus on OPLL and PROs.</p><p><strong>Methods: </strong>This prospective, multi-institutional study included 402 cervical OPLL patients from 2014 to 2017, categorized into elderly (≥75 y, n=79) and non-elderly (<75 y, n=323) groups. Clinical outcomes were assessed preoperatively and two years postoperatively using cervical Japanese Orthopedic Association (JOA) scores, visual analog scale (VAS) scores, and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). Multivariable regression analyses were conducted, adjusting for potential confounders, including demographic variables and imaging characteristics.</p><p><strong>Results: </strong>Elderly patients had worse preoperative JOA scores (9.6 vs. 11.1, P<0.01) and lower postoperative scores at two years (12.3 vs. 14.0, P<0.01). However, the improvement in JOA scores was comparable (2.7 vs. 3.0, P=0.48), with both exceeding the minimum clinically important difference (MCID). Complication rates and VAS score improvements were also comparable. JOACMEQ outcomes demonstrated significantly poorer upper extremity function in the elderly group following surgery (P=0.02), whereas no significant differences were observed between the two groups in other functional domains.</p><p><strong>Conclusion: </strong>Despite worse baseline neurological function, elderly OPLL patients achieved similar degrees of postoperative neurological improvement as non-elderly patients. However, upper extremity function is unlikely to show significant improvement following surgery in elderly patients.</p>\",\"PeriodicalId\":22193,\"journal\":{\"name\":\"Spine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-06-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BRS.0000000000005415\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005415","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Does Advanced Age Negatively Impact Treatment Outcomes of Cervical Ossification of the Posterior Longitudinal Ligament? A Prospective Multicenter Study.
Study design: A multicenter prospective cohort study.
Objective: To comprehensively evaluate the surgical impact, including patient-reported outcomes (PROs), in elderly patients with cervical ossification of the posterior longitudinal ligament (OPLL).
Summary of background data: With the rise of aging populations worldwide, understanding the impact of age on treatment outcomes for cervical OPLL has become increasingly important. Previous studies on degenerative cervical myelopathy have highlighted inconsistent outcomes for elderly patients, with limited focus on OPLL and PROs.
Methods: This prospective, multi-institutional study included 402 cervical OPLL patients from 2014 to 2017, categorized into elderly (≥75 y, n=79) and non-elderly (<75 y, n=323) groups. Clinical outcomes were assessed preoperatively and two years postoperatively using cervical Japanese Orthopedic Association (JOA) scores, visual analog scale (VAS) scores, and the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). Multivariable regression analyses were conducted, adjusting for potential confounders, including demographic variables and imaging characteristics.
Results: Elderly patients had worse preoperative JOA scores (9.6 vs. 11.1, P<0.01) and lower postoperative scores at two years (12.3 vs. 14.0, P<0.01). However, the improvement in JOA scores was comparable (2.7 vs. 3.0, P=0.48), with both exceeding the minimum clinically important difference (MCID). Complication rates and VAS score improvements were also comparable. JOACMEQ outcomes demonstrated significantly poorer upper extremity function in the elderly group following surgery (P=0.02), whereas no significant differences were observed between the two groups in other functional domains.
Conclusion: Despite worse baseline neurological function, elderly OPLL patients achieved similar degrees of postoperative neurological improvement as non-elderly patients. However, upper extremity function is unlikely to show significant improvement following surgery in elderly patients.
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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