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

Yoon Ha, Bong Ju Moon, Nam Kyu You, Seon Jin Yoon, DongAh Shin, Seong Yi, Keung Nyun Kim, Hyun Chul Shin, Do Heum Yoon

Research output: Contribution to journalArticle

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)164-171
Number of pages8
JournalWorld Neurosurgery
Volume90
DOIs
Publication statusPublished - 2016 Jun 1

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Ossification of Posterior Longitudinal Ligament
Reoperation
Surgical Decompression
Visual Analog Scale
Pathologic Constriction

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Ha, Yoon ; Moon, Bong Ju ; You, Nam Kyu ; Yoon, Seon Jin ; Shin, DongAh ; Yi, Seong ; Kim, Keung Nyun ; Shin, Hyun Chul ; Yoon, Do Heum. / Clinical Characteristics and Surgical Outcome of Revision Surgery in Patients with Cervical Ossification of the Posterior Longitudinal Ligament. In: World Neurosurgery. 2016 ; Vol. 90. pp. 164-171.
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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.",
author = "Yoon Ha and Moon, {Bong Ju} and You, {Nam Kyu} and Yoon, {Seon Jin} and DongAh Shin and Seong Yi and Kim, {Keung Nyun} and Shin, {Hyun Chul} and Yoon, {Do Heum}",
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Clinical Characteristics and Surgical Outcome of Revision Surgery in Patients with Cervical Ossification of the Posterior Longitudinal Ligament. / Ha, Yoon; Moon, Bong Ju; You, Nam Kyu; Yoon, Seon Jin; Shin, DongAh; Yi, Seong; Kim, Keung Nyun; Shin, Hyun Chul; Yoon, Do Heum.

In: World Neurosurgery, Vol. 90, 01.06.2016, p. 164-171.

Research output: Contribution to journalArticle

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AU - You, Nam Kyu

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AU - Shin, DongAh

AU - Yi, Seong

AU - Kim, Keung Nyun

AU - Shin, Hyun Chul

AU - Yoon, Do Heum

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N2 - 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.

AB - 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.

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