Evaluating the demographics and complications of North American surgical patients with ossification of the posterior longitudinal ligament

Authors

Aaron Phung, Georgetown University School of Medicine, Georgetown University, Washington, DC, USA.
Justin Hyde, Georgetown University School of Medicine, Georgetown University, Washington, DC, USA.
Justin Azmoodeh, Georgetown University School of Medicine, Georgetown University, Washington, DC, USA.
Theodore Quan, Department of Orthopaedic Surgery, George Washington University, Washington, DC, USA.
Lancelot Benn, Department of Orthopaedic Surgery, University of Missouri, Kansas City, MO, USA.
Christopher P. Bellaire, Department of Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA.
Oliver Tannous, Georgetown University School of Medicine, Georgetown University, Washington, DC, USA; Medstar Orthopaedic Institute, MedStar Washington Hospital Center, Washington, DC, USA.
Joseph Ferguson, Department of Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA.
Seyed B. Kalantar, Department of Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA.
David Weiner, Medstar Orthopaedic Institute at Medstar Southern Maryland Hospital, USA.
Andrew Mo, Medstar Orthopaedic Institute at Medstar Mongomery Medical Center, USA.
Fred Mo, Department of Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA.
Sean Bae, Georgetown University School of Medicine, Georgetown University, Washington, DC, USA.
Ala Alshomali, Georgetown University School of Medicine, Georgetown University, Washington, DC, USA.
Crisanto L. Macaraeg, Medstar Hospital Research Institute, Washington, DC, USA.
Kevin Yoon, Medstar Orthopaedic Institute, MedStar Washington Hospital Center, Washington, DC, USA.
Jonathan P. Japa, Medstar Orthopaedic Institute, MedStar Washington Hospital Center, Washington, DC, USA.
Mark Ehioghae, Medstar Orthopaedic Institute, MedStar Washington Hospital Center, Washington, DC, USA.
Addisu Mesfin, Georgetown University School of Medicine, Georgetown University, Washington, DC, USA; Department of Orthopaedic Surgery, Georgetown University School of Medicine, Washington, DC, USA; Medstar Orthopaedic Institute, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: amesfin@gmail.com.

Document Type

Journal Article

Publication Date

2-1-2026

Journal

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

Volume

144

DOI

10.1016/j.jocn.2025.111790

Keywords

Cervical spine; Cervical spine surgery; Cervical stenosis; Myelopathy; OPLL; Ossification of posterior longitudinal ligament; Spine

Abstract

INTRODUCTION: Ossification of the posterior longitudinal ligament (OPLL) is a hyperostotic spinal condition resulting from progressive endochondral ossification of the posterior longitudinal ligament, leading to spinal canal narrowing and spinal cord compression. Primarily seen in East Asian countries, OPLL has been increasingly recognized in North American cohorts. This study aims to evaluate the demographic characteristics and outcomes of patients undergoing surgery for OPLL in a North American cohort. METHODS: This was a single-center retrospective cohort study of patients with OPLL undergoing surgery between July 2011 and November 2024. Data collected included demographic information, body mass index (BMI), comorbidities, surgical approach, OPLL classification, and K-line measurement. Estimated blood loss (EBL), intra/post-operative complications, length of stay, and disposition status were also recorded. Descriptive statistics and multivariable analyses were conducted with a p value < 0.05 considered to be statistically significant. RESULTS: In total, 81 patients underwent surgery for OPLL (mean age of 60 years; 50.6 % male). Most of the patients were Black (43 patients, 53.1 %).The mean BMI was 33.1 kg/m. Forty-four patients (54.3 %) had diabetes. Most of the surgeries were elective (88.9 %). The classification of OPLL for the patients were: 31.7 % segmental, 20 % continuous, and 40 % mixed. 73.3 % of the patients had a positive K-line. Surgically, the posterior approach (41 patients, 50.6 %) was more common. A posterior approach was more likely to be utilized for patients with a positive K-line measurement (p = 0.029). Obesity was associated with increased EBL (p = 0.032). Five patients experienced intraoperative complications. The mean length of stay was 6.5 days, and average follow-up was 20.4 months. Three patients (3.7 %) passed post-operatively, and none underwent reoperation. CONCLUSION: This study highlights the demographic and clinical characteristics of OPLL in a diverse North American cohort. Surgical management, predominantly via anterior or posterior approaches, was associated with low complication rates and no reoperations during follow-up.

APA Citation

Phung, Aaron; Hyde, Justin; Azmoodeh, Justin; Quan, Theodore; Benn, Lancelot; Bellaire, Christopher P.; Tannous, Oliver; Ferguson, Joseph; Kalantar, Seyed B.; Weiner, David; Mo, Andrew; Mo, Fred; Bae, Sean; Alshomali, Ala; Macaraeg, Crisanto L.; Yoon, Kevin; Japa, Jonathan P.; Ehioghae, Mark; and Mesfin, Addisu, "Evaluating the demographics and complications of North American surgical patients with ossification of the posterior longitudinal ligament" (2026). GW Authored Works. Paper 8342.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8342

Department

School of Medicine and Health Sciences Resident Works