Clinical efficacy and complications of 10 surgical interventions for cervical ossification of the posterior longitudinal ligament: an updated systematic review and network meta-analysis

作者：Xiao Chen, Yuanhe Fan, Jie Chen, Hongliang Tu · 发表于：Journal of Orthopaedic Surgery and Research · 年份：2025 · DOI：10.1186/s13018-025-05878-x · 被引用次数：6 · 研究领域：Cervical and Thoracic Myelopathy、Spine and Intervertebral Disc Pathology、Scoliosis diagnosis and treatment

BACKGROUND: The optimal surgical techniques for cervical ossification of the posterior longitudinal ligament (OPLL) remain controversial due to insufficient high-level evidence. We investigated the following surgical approaches for cervical OPLL: anterior decompression and fusion (ADF), anterior cervical corpectomy and fusion (ACCF), anterior controllable antedisplacement fusion (ACAF), anterior cervical discectomy and fusion (ACDF), posterior decompression with instrumented fusion (PDIF), posterior decompression and fusion (PDF), laminectomy (LC), laminoplasty (LP), laminectomy with fusion (LF), and vertebral body sliding osteotomy (VBSO). METHODS: We systematically searched PubMed, Embase, Ovid, the Cochrane Library, and Web of Science from database inception through October 30, 2024. Our search identified both randomized and non-randomized controlled trials compar ing the following surgical interventions: ACDF, ADF, ACCF, ACAF, PDIF, PDF, LC, LP, LF, and VBSO. The extracted data were subjected to network meta-analysis. Our analysis included the following outcome measures: Patient demographic characteristics, Japanese Orthopaedic Association (JOA) scores, JOA improvement rates, overall complication rates, excellent/good recovery rates, cervical lordosis characteristics, Visual Analog Scale (VAS) scores, Neck Disability Index (NDI) scores, surgical duration and intraoperative blood loss. RESULTS: In our analysis of 50 studies involving 8705 patients, ACAF demonstrated the mo...