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Miyagi M, Inoue G, Yoshii T, Egawa S, Sakai K, Kusano K, Nakagawa Y, Hirai T, Wada K, Katsumi K, Kimura A, Furuya T, Nagoshi N, Kanchiku T, Nagamoto Y, Oshima Y, Nakashima H, Ando K, Takahata M, Mori K, Nakajima H, Murata K, Matsunaga S, Kaito T, Yamada K, Kobayashi S, Kato S, Ohba T, Inami S, Fujibayashi S, Katoh H, Kanno H, Koda M, Takahashi H, Ikeda S, Imagama S, Kawaguchi Y, Takeshita K, Matsumoto M, Takaso M, Okawa A, Yamazaki M. Residual Neuropathic Pain in Postoperative Patients With Cervical Ossification of Posterior Longitudinal Ligament. Clin Spine Surg 2023; 36:E277-E282. [PMID: 36823706 DOI: 10.1097/bsd.0000000000001449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 01/25/2023] [Indexed: 02/25/2023]
Abstract
STUDY DESIGN A prospective multi-institutional observational study. OBJECTIVE To investigate and identify risk factors for residual neuropathic pain after surgery in patients with cervical ossification of posterior longitudinal ligament (c-OPLL). SUMMARY OF BACKGROUND DATA Patients with c-OPLL often require surgery for numbness and paralysis of the extremities; however, postoperative neuropathic pain can considerably deteriorate their quality of life. METHODS Out of 479 patients identified from multicenter c-OPLL registries between 2014 and 2017, 292 patients who could be followed up for 2 years postoperatively were reviewed, after excluding patients with nervous system comorbidities. Demographic details; medical history; radiographic factors including the K-line, spinal canal occupancy rate of OPLL, cervical kyphosis angle, and presence of spinal cord myelomalacia; preoperative Japanese Orthopaedic Association (JOA) score; surgical procedure (fusion or decompression surgery); postoperative neurological deterioration; and the visual analogue scale for pain and numbness in the upper extremities (U/E) or trunk/lower extremities (L/E) at baseline and at 2 years postoperatively were assessed. Patients were grouped into residual and non-residual groups based on a postoperative visual analogue scale ≥40 mm. Risk factors for residual neuropathic pain were evaluated by multiple logistic regression analysis. RESULTS The prevalence of U/E and L/E residual pain in postoperative c-OPLL patients was 51.7% and 40.4%, respectively. The U/E residual group had a poor preoperative JOA score and longer illness duration, and fusion surgery was more common in the residual group than in non-residual group. The L/E residual group was older with a poorer preoperative JOA score. On multivariate analysis, risk factors for U/E residual pain were long illness duration and poor preoperative JOA score, whereas those for L/E residual pain were age and poor preoperative JOA score. CONCLUSIONS The risk factors for residual spinal neuropathic pain after c-OPLL surgery were age, long duration of illness, and poor preoperative JOA score. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Masayuki Miyagi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Gen Inoue
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Toshitaka Yoshii
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Satoru Egawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Kenichiro Sakai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Saiseikai Kawaguchi General Hospital, Nishikawaguchi, Kawaguchishi, Saitama
| | - Kazuo Kusano
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Kudanzaka Hospital, Kudanminami, Chiyadaku
| | - Yukihiro Nakagawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Wakayama Medical University Kihoku hospital, Myoji, Katsuragi-cho, Itogun, Wakayama
| | - Takashi Hirai
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Kanichiro Wada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Zaifucho, Hirosaki, Aomori
| | - Keiichi Katsumi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, Asahimachidori, Chuo Ward, Niigata, Niigata
| | - Atsushi Kimura
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedics, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi
| | - Takeo Furuya
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Inohana, Chuo Ward, Chiba, Chiba
| | - Narihito Nagoshi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinanomachi, Shinjuku Ward, Tokyo
| | - Tsukasa Kanchiku
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine Kogushi, Ube, Yamaguchi
| | - Yukitaka Nagamoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Osaka Rosai Hospital, Nagasonecho, Sakaishi, Osaka
| | - Yasushi Oshima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hongo, Bunkyo-ku, Tokyo
| | - Hiroaki Nakashima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa Ward, Nagoya, Aichi
| | - Kei Ando
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa Ward, Nagoya, Aichi
| | - Masahiko Takahata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita, Nishi, Sapporo
| | - Kanji Mori
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga
| | - Hideaki Nakajima
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui
| | - Kazuma Murata
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical University, Nishishinjuku, Shinjuku-ku, Tokyo
| | - Shunji Matsunaga
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Imakiire General Hospital, Shimotatsuocho, Kagoshimashi
| | - Takashi Kaito
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Graduate School of Medicine, Osaka University Yamadaoka, Suita-shi, Osaka
| | - Kei Yamada
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Kurume University School of Medicine Asahi-machi, Kurume-shi, Fukuoka
| | - Sho Kobayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Shizuoka
| | - Satoshi Kato
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa
| | - Tetsuro Ohba
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, University of Yamanashi, Shimokato, Chuo Ward, Yamanashi
| | - Satoshi Inami
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi
| | - Shunsuke Fujibayashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto
| | - Hiroyuki Katoh
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Shimokasuya, Isehara, Kanagawa
| | - Haruo Kanno
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Seiryomachi, Aoba Ward, Sendai, Miyagi
| | - Masao Koda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki
| | - Hiroshi Takahashi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki
| | - Shinsuke Ikeda
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Shiro Imagama
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga
| | - Yoshiharu Kawaguchi
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Sugitani, Toyama, Japan
| | - Katsushi Takeshita
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedics, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi
| | - Morio Matsumoto
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinanomachi, Shinjuku Ward, Tokyo
| | - Masashi Takaso
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
| | - Atsushi Okawa
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Tokyo Medical and Dental University, Yushima, Bunkyo Ward, Tokyo
| | - Masashi Yamazaki
- Japanese Multicenter Research Organization for Ossification of the Spinal Ligament, Department of Orthopaedic Surgery, Kitasato University, Tokyo
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki
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