{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T02:01:30Z","timestamp":1794276090746,"version":"4.9.0"},"reference-count":21,"publisher":"The Korean Spinal Neurosurgery Society","issue":"3","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-neurospine.org"],"crossmark-restriction":true},"short-container-title":["Neurospine"],"published-print":{"date-parts":[[2025,9,30]]},"abstract":"<jats:p>Objective: To analyze long-term clinical and radiological outcomes after multilevel anterior osteotomy with posterior instrumentation in patients with ossification of posterior longitudinal ligament (OPLL)-induced myelopathy and cervical kyphosis.Methods: Patients who underwent multilevel anterior osteotomy with posterior instrumentation for OPLL-induced myelopathy and cervical kyphosis and had a minimum of 5-year follow-up were included. Clinical outcomes (Japanese Orthopaedic Association score system for cervical myelopathy [C-JOA], 12-item Short Form health survey [SF-12], Neck Disability Index [NDI]) and radiological parameters (C2\u20137 lordosis, center of gravity of the head [CGH]-C7 sagittal vertical axis [SVA], T1 slope) were analyzed at the preoperative, immediate postoperative, and latest follow-up timepoints.Results: Twenty-eight patients were included. The average follow-up period was 66.4 months. All clinical outcome parameters showed significant improvement. C-JOA, SF-12, and NDI showed significant improvement at latest follow-up (p&lt;0.001). C2\u20137 lordosis increased significantly immediately postoperatively (-6.0\u00b0\u00b110.4\u00b0) compared to preoperatively (+9.2\u00b0\u00b19.6\u00b0), and was largely maintained at latest follow-up (-5.7\u00b0\u00b19.4\u00b0). T1 slope significantly increased between the immediate postoperative timepoint (21.9\u00b0\u00b17.7\u00b0) and latest follow-up (24.2\u00b0\u00b19.5\u00b0) (p=0.046). CGH-C7 SVA significantly increased between the immediate postoperative timepoint (22.7\u00b114.8 mm) and latest follow-up (32.2\u00b122.6 mm) (p=0.046).Conclusion: Multilevel anterior osteotomy with posterior instrumentation is a safe and effective surgical option for OPLL-induced myelopathy with kyphotic cervical alignment. Future studies are required to investigate the forward tilting of cervical spine over time after surgery.<\/jats:p>","DOI":"10.14245\/ns.2550256.128","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T07:24:06Z","timestamp":1759130646000},"page":"623-630","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long-term Outcomes of Multilevel Anterior Cervical Osteotomy and Posterior Instrumentation for OPLL-Induced Myelopathy With Cervical 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between T1 slope and cervical alignment following multilevel posterior cervical fusion surgery: impact of T1 slope minus cervical lordosis","author":"Hyun","year":"2016"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000003813"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-07861-8"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.03.117"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2024.110869"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3171\/2023.12.spine23481"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23074"}],"container-title":["Neurospine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2550256-128.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2550256.128","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-neurospine.org\/upload\/pdf\/ns-2550256-128.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:25:05Z","timestamp":1782087905000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-neurospine.org\/journal\/view.php?doi=10.14245\/ns.2550256.128"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"URL":"https:\/\/doi.org\/10.14245\/ns.2550256.128","relation":{},"ISSN":["2586-6583","2586-6591"],"issn-type":[{"value":"2586-6583","type":"print"},{"value":"2586-6591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]},"assertion":[{"value":"2025-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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