Surgical Timing and Recovery After Cervical Decompression for OPLL

There's no upside to waiting if the patient is fit

What’s the Claim?

A large registry study found that among patients with ossification of the posterior longitudinal ligament (OPLL) and symptoms of cervical myelopathy treated surgically, longer symptom duration was associated with poorer recovery, specifically:

  • Recovery of upper extremity function, lower extremity function, and bladder function all were less likely to occur in patients with more than 2 years of symptoms than in those who had surgery before 2 years of symptoms (patients with symptoms of greater than 2 years’ duration also had lower odds of clinically important improvement on a myelopathy PROM)
  • Only 30% of patients whose symptoms were present for ≥ 5 years registered a clinically important improvement after surgery

About half the patients were treated with laminoplasty, and most of the rest were treated with decompression and fusion (about evenly split between anterior and posterior approaches).

How’s It Stack Up?