{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:14:30Z","timestamp":1777929270901,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Health Labour Sciences Research Grand","award":["20FC1038"],"award-info":[{"award-number":["20FC1038"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The objective of this study was to clarify the characteristics of immediate neurological deterioration (ND) after ambulation and its potential preventative measures using multi-rod reinforcement during posterior decompression and fusion (PDF) with instrumentation for thoracic ossification of the posterior longitudinal ligament (T-OPLL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Study 1: Fifteen patients with T-OPLL who underwent PDF before 2020 were included. Demographic, radiographic, intraoperative, and postoperative data were compared between the 6 patients with ND and 9 patients without ND after ambulation. Study 2: The primary (incidence of ND after ambulation) and the secondary (postoperative hospital stay) outcomes were compared between 15 patients with a multi-rod construct since 2020 (multi-rod group) and 15 patients with a dual-rod construct before 2020 (dual-rod group; patients who were indicated in study 1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Study 1: ND after ambulation tends to occur only in the upper or middle thoracic spine. The mean maximum OPLL occupation ratio was significantly different between the groups (ND vs non-ND, 67.7% vs 53.4%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .021). Study 2: The incidence of ND after ambulation (dual-rod vs multi-rod, 40% vs 6.7%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .040) and the mean duration of the postoperative hospital stay (dual-rod vs multi-rod, 51.2 days vs 25.6 days;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .007) were significantly different between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immediate ND after ambulation occurs in the upper or middle thoracic spine, and a higher maximum OPLL occupation ratio is a significant risk factor. Multi-rod reinforcement can reduce its incidence, regardless of maximum OPLL occupation ratio, and duration of postoperative hospital stay, which could be a potential preventative measure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536251338903","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T20:28:07Z","timestamp":1746044887000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Preventing neurological deterioration after ambulation in posterior decompression and fusion for thoracic ossification of the posterior longitudinal ligament"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7325-4357","authenticated-orcid":false,"given":"Toru","family":"Funayama","sequence":"first","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masao","family":"Koda","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Noguchi","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-184X","authenticated-orcid":false,"given":"Kousei","family":"Miura","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisanori","family":"Gamada","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Okuwaki","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kotaro","family":"Sakashita","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Sunami","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3679-9438","authenticated-orcid":false,"given":"Masaki","family":"Tatsumura","sequence":"additional","affiliation":[{"name":"Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"University of Tsukuba"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000220834.22131.fb"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-1266-4"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2015.07.027"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002703"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.22603\/ssrr.2017-0044"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-015-1106-z"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2016.1142056"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2019.08.004"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2018.04.032"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-009-0956-2"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.3171\/2010.3.SPINE09237"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2018.0177"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1579662"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-019-06047-5"},{"key":"e_1_3_4_16_2","first-page":"1","article-title":"Anterior decompression through a posterior approach for thoracic myelopathy caused by ossification of the posterior longitudinal ligament: a novel concept in anterior decompression and technical notes with the preliminary outcomes","volume":"24","author":"Kanno H","year":"2021","unstructured":"Kanno H, Aizawa T, Hashimoto K, et al. Anterior decompression through a posterior approach for thoracic myelopathy caused by ossification of the posterior longitudinal ligament: a novel concept in anterior decompression and technical notes with the preliminary outcomes. J Neurosurg Spine 2021; 24: 1\u201311.","journal-title":"J Neurosurg Spine"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.22603\/ssrr.2021-0079"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1987.66.4.0511"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000193940.75354.e5"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1179\/2045772311Y.0000000029"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198107000-00005"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001585"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000155033.63557.9c"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.3171\/2011.3.SPINE10716"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31817615c5"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.04.031"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.22603\/ssrr.2022-0131"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001643"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536251338903","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10225536251338903","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536251338903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:32:00Z","timestamp":1777678320000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10225536251338903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1177\/10225536251338903"],"URL":"https:\/\/doi.org\/10.1177\/10225536251338903","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"article-number":"10225536251338903"}}