Surgical interventions for cervical spondylosis due to ossification of posterior longitudinal ligament: A meta-analysis.

BACKGROUND: Aim of this study was to evaluate the effectiveness of various surgical interventions for the management of cervical spondylosis due to the ossification of posterior longitudinal ligament (OPLL).

METHODS: After a comprehensive literature search in electronic databases, studies were selected by following pre-determined eligibility criteria. Random effects meta-analyses were performed to estimate the effect sizes of various surgical approaches in improving Japanese Orthopedic Association (JOA) scores at latest follow-up and meta-regression analyses were carried out to examine the factors affecting the change in JOA score.

RESULTS: Twenty-three studies [1576 patients; 57.83 (95% confidence interval, 95% CI: 55.98-59.68] years of age; and 73 (70-76) % males; follow-up 55.4 ± 25.7 (range 12-170) months] were included in the meta-analysis. All surgical interventions significantly (P < .00001) improved JOA score. Anterior surgical approaches had an effect size of 4.80 [4.10-5.50] and posterior approaches with laminectomy and laminoplasty improved JOA score by 3.57 [2.39-4.75] and 3.99 [3.65-4.32], respectively. Improvement in JOA score was significantly inversely related to the preoperative JOA score (P < .00001). Surgical interventions did not significantly affect cervical lordosis at the latest follow-up.

CONCLUSION: Surgical interventions for cervical spondylosis due to OPLL significantly improve JOA score as observed at the latest follow-up and this is found to be significantly inversely associated with preoperative JOA score.