Evidence map›Paper›PMID 31607084›Full record

ArticleNeurospine2019

The Clinical Implications and Complications of Anterior Versus Posterior Surgery for Multilevel Cervical Ossification of the Posterior Longitudinal Ligament; An Updated Systematic Review and Meta-Analysis.

Dong Hwan Kim, Chang-Hyun Lee, Young San Ko, Seung Heon Yang, Chi Heon Kim, Sung Bae Park, Chun Kee Chung

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurospine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Dong Hwan KimDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Chang-Hyun LeeDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Young San KoDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Seung Heon YangDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Chi Heon KimDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Sung Bae ParkDepartment of Neurosurgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.
Chun Kee ChungDepartment of Neurosurgery, Seoul National University Hospital, Seoul, Korea.

Funding

Ministry of EducationNational Research Foundation of Korea 2017R1D1A3B03028470
6 · The paper itself

Abstract

objectiveTheoretically, the optimal approach is determined by the status of ossification of the posterior longitudinal ligament (OPLL) and sagittal alignment. However, there have long been disputes about the optimum surgical approach of OPLL. This study is to compare risk-effectiveness between anterior decompression and fusion (ADF) and laminoplasty and laminectomy with fusion (LP/LF) for the patient with cervical myelopathy due to multilevel cervical OPLL.

methodsWe searched core databases, and compared complication and outcomes between ADF and LP/LF for patients with multiple OPLL for the cervical spine. The incidence of complications such as neurologic deterioration, C5 palsy, and dura tear was assessed. Changes in JOA score between baseline and final evaluations were assessed for 2 groups. The minimal clinically important difference (MCID) was utilized for evaluating clinical significance. We calculated Peto odds ratio (POR) and mean difference for the incidence and continuous variables, respectively.

resultsWe included data from 21 articles involving 3,872 patients with cervical myelopathy with OPLL. Major neurologic deficits such as paraplegia, quadriplegia developed 2.17% in the ADF group and 1.11% in the LP/LF group, and POR was 2.16. Mean difference of JOA score improvement of 2 groups was 1.30, and the mean difference showed a statistical significance. However, 1.3 points of JOA improvement cannot reach 2.5 points of the MCID.

conclusionAnterior surgery often led to rare but critical complications, and the difference of neurological improvement between 2 groups was below a clinically meaningful level. Posterior surgeries may be appropriate in the treatment of multilevel cervical myelopathy with OPLL.

Indexed as

Anterior decompression and fusionComplicationLaminoplastyOssification of the posterior longitudinal ligamentRecovery rate

Identifiers

PMID31607084
PMCPMC6790730

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.