OBJECTIVE: To investigate surgical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL) when performed by board-certified spine (BCS) or non-BCS (NBCS) surgeons.
METHODS: We included 203 patients with cervical OPLL who were followed for a minimum of 1 year after surgery. Demographic information, medical history, and imaging findings were collected. Clinical outcomes were assessed preoperatively and at the final follow-up using the Japanese Orthopedic Association (JOA) score and the visual analog scale (VAS) for the neck. We compared outcomes between BCS surgeons, who must meet several requirements, including experience in more than 300 spinal surgeries, and NBCS surgeons.
RESULTS: BCS surgeons performed 124 out of 203 cases, while NBCS surgeons were primary in 79 cases, with 73.4% were directly supervised by a BCS surgeon. There was no statistically significant difference in surgical duration, estimated blood loss, and perioperative complication rates between the BCS and NBCS groups. Moreover, no statistically significant group differences were observed in each position of the C2-7 angle and cervical range of motion at preoperation and the final follow-up. Preoperative and final follow-up JOA scores, VAS for the neck, and JOA score recovery rate were comparable between the two groups.
CONCLUSIONS: Surgical outcomes, including functional recovery, complication rates, and cervical dynamics, were comparable between the BCS and NBCS groups. Consequently, posterior decompression for cervical OPLL is considered safe and effective when conducted by junior surgeons who have undergone training and supervision by experienced spine surgeons.
目的:探讨后路减压治疗颈椎后纵韧带骨化症(OPLL)后,由板认证脊柱(BCS)或非BCS(NBCS)外科医生进行的手术效果。
方法:我们纳入了203例宫颈OPLL患者,术后随访至少1年。人口统计信息,病史,并收集影像学检查结果.使用日本骨科协会(JOA)评分和颈部视觉模拟量表(VAS)评估术前和最终随访时的临床结果。我们比较了BCS外科医生的结果,谁必须满足几个要求,包括300多次脊柱手术的经验,和NBCS外科医生。
结果:BCS外科医生在203例中完成了124例,而NBCS外科医生在79例中是主要的,73.4%由BCS外科医生直接监督。手术时间差异无统计学意义,估计失血量,BCS组和NBCS组之间的围手术期并发症发生率。此外,术前和最终随访时,C2-7角的每个位置和颈椎活动范围均无统计学差异。术前和最终随访JOA评分,颈部的VAS,两组间JOA评分恢复率具有可比性。
结论:手术结果,包括功能恢复,并发症发生率,和子宫颈动力学,BCS和NBCS组之间具有可比性。因此,由经过经验丰富的脊柱外科医生培训和监督的初级外科医生进行颈椎OPLL后路减压被认为是安全有效的。