{"title":"预测黄韧带骨化手术预后的因素:一项系统回顾和荟萃分析","authors":"Anish Tayal , Pragya Mitra , Aneeket Modak , Sucharu Asri , Kanwaljeet Garg","doi":"10.1016/j.jocn.2025.111649","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The study aimed to determine the association between demographics, clinical presentation, radiological findings, and intraoperative characteristics of patients with thoracic ossification of ligamentum flavum (OLF) surgery and their postoperative outcomes.</div></div><div><h3>Methods</h3><div>PubMed, Ovid, Embase, and Web of Sciences databases were searched until July 2023 to include articles regarding the prognostic factors for thoracic OLF surgery. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. The outcome of surgery was evaluated by calculating the recovery rate (RR), as follows: RR = (postoperative Japanese Orthopedic Association (JOA) score − preoperative JOA score)/(11 − preoperative JOA score). Meta-analyses Of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Furthermore, factors associated with outcome were assessed separately within open and minimally invasive surgery (MIS) subgroups.</div></div><div><h3>Results</h3><div>Thirty-six studies with 1,511 patients were included. RR was associated with age (p-value = 0.012), JOA score (p-value < 0.001), ossified region (middle vs. lower thoracic spine: p-value = 0.042), intramedullary signal intensity change on T2-weighted magnetic resonance imaging (p-value < 0.001), and occurrence of dural ossification (p-value = 0.006). On subgroup analysis, JOA score (p-value < 0.001) and operation time (p-value = 0.014) were associated with outcomes for patients managed with an open surgical approach, while none for those operated with the MIS technique.</div></div><div><h3>Conclusion</h3><div>Although surgery is the cornerstone of the management of OLF, careful patient prognostication should be performed considering the aforementioned factors. Further, high-quality research is warranted to confirm the findings of this study.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111649"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors predicting the outcome of thoracic ossification of ligamentum flavum (OLF) surgery: A systematic review and meta-analysis\",\"authors\":\"Anish Tayal , Pragya Mitra , Aneeket Modak , Sucharu Asri , Kanwaljeet Garg\",\"doi\":\"10.1016/j.jocn.2025.111649\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The study aimed to determine the association between demographics, clinical presentation, radiological findings, and intraoperative characteristics of patients with thoracic ossification of ligamentum flavum (OLF) surgery and their postoperative outcomes.</div></div><div><h3>Methods</h3><div>PubMed, Ovid, Embase, and Web of Sciences databases were searched until July 2023 to include articles regarding the prognostic factors for thoracic OLF surgery. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. The outcome of surgery was evaluated by calculating the recovery rate (RR), as follows: RR = (postoperative Japanese Orthopedic Association (JOA) score − preoperative JOA score)/(11 − preoperative JOA score). Meta-analyses Of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Furthermore, factors associated with outcome were assessed separately within open and minimally invasive surgery (MIS) subgroups.</div></div><div><h3>Results</h3><div>Thirty-six studies with 1,511 patients were included. RR was associated with age (p-value = 0.012), JOA score (p-value < 0.001), ossified region (middle vs. lower thoracic spine: p-value = 0.042), intramedullary signal intensity change on T2-weighted magnetic resonance imaging (p-value < 0.001), and occurrence of dural ossification (p-value = 0.006). On subgroup analysis, JOA score (p-value < 0.001) and operation time (p-value = 0.014) were associated with outcomes for patients managed with an open surgical approach, while none for those operated with the MIS technique.</div></div><div><h3>Conclusion</h3><div>Although surgery is the cornerstone of the management of OLF, careful patient prognostication should be performed considering the aforementioned factors. Further, high-quality research is warranted to confirm the findings of this study.</div></div>\",\"PeriodicalId\":15487,\"journal\":{\"name\":\"Journal of Clinical Neuroscience\",\"volume\":\"142 \",\"pages\":\"Article 111649\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0967586825006228\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0967586825006228","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Factors predicting the outcome of thoracic ossification of ligamentum flavum (OLF) surgery: A systematic review and meta-analysis
Background
The study aimed to determine the association between demographics, clinical presentation, radiological findings, and intraoperative characteristics of patients with thoracic ossification of ligamentum flavum (OLF) surgery and their postoperative outcomes.
Methods
PubMed, Ovid, Embase, and Web of Sciences databases were searched until July 2023 to include articles regarding the prognostic factors for thoracic OLF surgery. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool. The outcome of surgery was evaluated by calculating the recovery rate (RR), as follows: RR = (postoperative Japanese Orthopedic Association (JOA) score − preoperative JOA score)/(11 − preoperative JOA score). Meta-analyses Of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Furthermore, factors associated with outcome were assessed separately within open and minimally invasive surgery (MIS) subgroups.
Results
Thirty-six studies with 1,511 patients were included. RR was associated with age (p-value = 0.012), JOA score (p-value < 0.001), ossified region (middle vs. lower thoracic spine: p-value = 0.042), intramedullary signal intensity change on T2-weighted magnetic resonance imaging (p-value < 0.001), and occurrence of dural ossification (p-value = 0.006). On subgroup analysis, JOA score (p-value < 0.001) and operation time (p-value = 0.014) were associated with outcomes for patients managed with an open surgical approach, while none for those operated with the MIS technique.
Conclusion
Although surgery is the cornerstone of the management of OLF, careful patient prognostication should be performed considering the aforementioned factors. Further, high-quality research is warranted to confirm the findings of this study.
期刊介绍:
This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology.
The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.