OPLL Surgery Works as Well as Surgery for Other DCMs

Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in elderly people, and one form of it —ossification of the posterior longitudinal ligament, or OPLL—occurs quite frequently in younger patients. The March 2, 2016 JBJS features a prospective, multicenter Level II study by Nakashima et al. demonstrating that surgical decompression for OPLL yields functional and quality-of-life improvements comparable to those seen with surgical decompression in patients with other forms of DCM, such as spondylosis and disc herniation.

The authors measured function and quality-of-life before and two years after surgical decompression in more than 400 patients, 28% of whom had OPLL and the remainder of whom had other forms of DCM. With most two-year outcomes being comparable between the two groups, the authors found only two notable differences:

• A higher risk of perioperative complications in the OPLL group, although there were no between-group differences in the rate of neurological complications.
• Lower social functioning scores on the SF-36 among the OPLL patients.

The authors conclude that the comparable surgical outcomes “support the inclusion of both OPLL and other forms of degenerative myelopathy under the single umbrella of DCM.”