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Clinical Characteristics and Surgical Outcome of Revision Surgery in Patients with Cervical Ossification of the Posterior Longitudinal Ligament

Authors
 Yoon Ha  ;  Bong Ju Moon  ;  Nam Kyu You  ;  Seon Jin Yoon  ;  Dong Ah Shin  ;  Seong Yi  ;  Keung Nyun Kim  ;  Hyun Chul Shin  ;  Do Heum Yoon 
Citation
 World Neurosurgery, Vol.90 : 164-171, 2016 
Journal Title
 World Neurosurgery 
ISSN
 1878-8750 
Issue Date
2016
MeSH
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cervical Vertebrae/surgery ; Comorbidity ; Decompression, Surgical/utilization ; Diskectomy ; Female ; Humans ; Laminectomy ; Longitudinal Studies ; Male ; Middle Aged ; Neck Pain/diagnosis ; Neck Pain/epidemiology* ; Neck Pain/prevention & control ; Ossification of Posterior Longitudinal Ligament/diagnosis ; Ossification of Posterior Longitudinal Ligament/epidemiology* ; Ossification of Posterior Longitudinal Ligament/surgery* ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology* ; Postoperative Complications/prevention & control ; Prevalence ; Reoperation/utilization* ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Spinal Stenosis/diagnosis ; Spinal Stenosis/epidemiology* ; Spinal Stenosis/surgery* ; Treatment Outcome
Keywords
Cervical ossification of posterior longitudinal ligament ; JOA ; Myelopathy ; Revision surgery ; VAS
Abstract
OBJECTIVE: To investigate the clinical characteristics and surgical outcome of revision surgery after first surgical decompression of cervical ossification of posterior longitudinal ligament. METHODS: A retrospective analysis was performed of 913 patients who underwent surgical decompression of cervical ossification of posterior longitudinal ligament from 1998 to 2012. Of these patients, 35 underwent revision surgery. Neurologic and surgical outcomes, radiologic findings, surgical procedures, and complications were evaluated. Indications for revision surgery were compared between early (≤24 months after the first surgery) and delayed (>24 months after the first surgery) revision surgery. RESULTS: There was a higher prevalence of male patients with revision surgery (89%) compared with patients without revision surgery (71.2%, P = 0.033). Preoperative Japanese Orthopaedic Association score was significantly lower in patients with revision surgery (11.5 vs. 12.7, P < 0.01). Visual analog scale score for neck pain was improved both without revision surgery (from 3.0 to 2.1, P < 0.001) and with revision surgery (from 3.0 to 2.2, P < 0.001) patients. Symptomatic residual stenosis was a more frequent cause of revision surgery in early revision surgery than in delayed revision surgery (75% vs. 25%, P < 0.001). In delayed revision surgery, growth of ossification of posterior longitudinal ligament (50%) was the primary cause of revision surgery. CONCLUSIONS: Clinical outcomes (Japanese Orthopaedic Association and visual analog scale scores) of revision surgery are similar to the outcomes of patients who did not require revision surgery. Residual stenosis after the index surgery is the most common indication for early revision surgery. To avoid early revision surgery, surgeons should carefully consider achieving circumferential decompression of the spinal canal during initial surgery.
Full Text
http://www.sciencedirect.com/science/article/pii/S1878875016002990?via%3Dihub
DOI
10.1016/j.wneu.2016.02.054
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
김긍년(Kim, Keung Nyun)
신동아(Shin, Dong Ah) ORCID logo https://orcid.org/0000-0002-5225-4083
윤도흠(Yoon, Do Heum) ORCID logo https://orcid.org/0000-0003-1452-5724
윤선진(Yoon, Seon Jin) ORCID logo https://orcid.org/0000-0002-3255-5081
이성(Yi, Seong)
하윤(Ha, Yoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152521
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