Open AccessDoes surgical treatment increase the progression of spinal cord injury in patients with ossification of posterior longitudinal ligament of cervical spine? A systematic review and meta-analysis
Author(s) -
Zhang Bi,
Yufei Zhang,
Bin Ma,
Jun Ma,
Xiaoyong Chen,
Junjie Li,
Haifeng Yuan
Publication year - 2021
Publication title -
journal of orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 40
eISSN - 2309-4990
pISSN - 1022-5536
DOI - 10.1177/2309499020981782
Subject(s) - medicine , meta analysis , surgery , ossification of the posterior longitudinal ligament , orthopedic surgery , spinal cord injury , ossification , range of motion , cervical spine , conservative treatment , randomized controlled trial , spinal cord , myelopathy , psychiatry
Purpose: The purpose of this study is to explore if the surgical treatment will accelerate the progression of spinal cord injury (SCI) in patients with cervical Ossification of the posterior longitudinal ligament (OPLL) and if surgery will have better curative effect than conservative treatment.Methods: An extensive search of literature was implemented in PubMed, EMBASE, and other online databases. The quality of the included articles was evaluated according to the Newcastle-Ottawa Quality Assessment Scale, as recommended by the Cochrane manual, and meta-analysis was performed using the review manage5.3 software.Results: No obvious statistical difference was observed in the rate of SCI progression (P > 0.05, OR 1.15 [0.66, 2.00]), cervical range of motion, (P > 0.05, weighted mean difference (WMD) 4.52 [−5.75, 14.79]), and Japanese Orthopedic Association scores before surgery (P > 0.05, WMD −2.78 [−7.87, 2.32]) between the surgical group and conservative treatment group. However the surgical group illustrated obviously higher neurofunctional recovery rate (P < 0.05, OR 6.07 [1.55, 23.78]) and postoperative JOA score of the surgery group (P < 0.05, WMD −0.77 [−1.21, −0.33]) than conservative group.Conclusions: Based on this meta-analysis, there is not enough evidence to indicate that surgery will accelerate the progress of SCI with OPLL. However, the superiority of surgical efficacy can be observed over conservative treatment in terms of relieving neurological symptoms.