North American Spine Society journal · 2026
Baseline characteristics, perioperative complications, and 1-year outcomes in cervical OPLL versus cervical spondylotic myelopathy: a multicenter retrospective cohort study.
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Oshima Yasushi, Doi Toru, Nakamoto Hideki, Nakarai Hiroyuki, Sato Yusuke, Sasaki Katsuyuki, Tachibana Naohiro, Oguchi Fumihiko, Saiki Fumiko, Fukushima Masayoshi, Horii Chiaki, Okamoto Naoki, Hirai Shima, Oshina Masahito, Miyahara Junya, Masuda Kazuhiro, Kato So, Taniguchi Yuki, Tanaka Sakae
Аннотация
BACKGROUND: Cervical ossification of the posterior longitudinal ligament (OPLL) is an important cause of degenerative cervical myelopathy. Unlike cervical spondylotic myelopathy (CSM), OPLL has been increasingly recognized as a distinct phenotype with potential systemic metabolic and mineral-regulatory associations. The purpose of this study was to compare baseline characteristics, perioperative complications, and patient-reported outcomes (PROs) between cervical OPLL and CSM.
METHODS: This retrospective multicenter cohort study included patients undergoing surgery for cervical myelopathy due to OPLL or CSM at 13 high-volume spine centers. Baseline characteristics, comorbidities, serum phosphate levels, perioperative complications, and outcomes were assessed. PROs comprised numerical rating scales for neck and arm pain, the Neck Disability Index, the EuroQol 5-Dimension, the 12-Item Short Form Survey, and the Core Outcome Measures Index. Outcomes were evaluated preoperatively and at 1 year. Inverse probability of treatment weighting was used to adjust for baseline differences.
RESULTS: A total of 1,824 patients were included (OPLL, n = 317; CSM, n = 1,507). Patients with OPLL were younger, more frequently male, and had higher body mass index. Diabetes was more prevalent and serum phosphate levels were lower in OPLL, and these differences persisted after IPW adjustment. Crude perioperative neurologic complications were more frequent in OPLL, but the difference was attenuated after weighting. Postoperative PROs at 1 year did not differ significantly between groups.
CONCLUSIONS: Cervical OPLL and CSM demonstrate distinct baseline profiles, particularly with respect to metabolic comorbidities, body habitus, and serum phosphate levels. Although crude perioperative complication rates were higher in OPLL, these differences were largely explained by baseline characteristics after adjustment.
METHODS: This retrospective multicenter cohort study included patients undergoing surgery for cervical myelopathy due to OPLL or CSM at 13 high-volume spine centers. Baseline characteristics, comorbidities, serum phosphate levels, perioperative complications, and outcomes were assessed. PROs comprised numerical rating scales for neck and arm pain, the Neck Disability Index, the EuroQol 5-Dimension, the 12-Item Short Form Survey, and the Core Outcome Measures Index. Outcomes were evaluated preoperatively and at 1 year. Inverse probability of treatment weighting was used to adjust for baseline differences.
RESULTS: A total of 1,824 patients were included (OPLL, n = 317; CSM, n = 1,507). Patients with OPLL were younger, more frequently male, and had higher body mass index. Diabetes was more prevalent and serum phosphate levels were lower in OPLL, and these differences persisted after IPW adjustment. Crude perioperative neurologic complications were more frequent in OPLL, but the difference was attenuated after weighting. Postoperative PROs at 1 year did not differ significantly between groups.
CONCLUSIONS: Cervical OPLL and CSM demonstrate distinct baseline profiles, particularly with respect to metabolic comorbidities, body habitus, and serum phosphate levels. Although crude perioperative complication rates were higher in OPLL, these differences were largely explained by baseline characteristics after adjustment.