{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:03:39Z","timestamp":1782601419111,"version":"3.54.5"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The purpose of this study was to compare the effectiveness and safety of anterior corpectomy and fusion (ACF) with laminoplasty for the treatment of patients diagnosed with cervical ossification of the posterior longitudinal ligament (OPLL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors searched electronic databases for relevant studies that compared the use of ACF with laminoplasty for the treatment of patients with OPLL. Data extraction and quality assessment were conducted, and statistical software was used for data analysis. The random effects model was used if there was heterogeneity between studies; otherwise, the fixed effects model was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 10 nonrandomized controlled studies involving 819 patients were included. Postoperative Japanese Orthopaedic Association (JOA) score (p = 0.02, 95% CI 0.30\u20132.81) was better in the ACF group than in the laminoplasty group. The recovery rate was superior in the ACF group for patients with an occupying ratio of OPLL of \u2265 60% (p &lt; 0.00001, 95% CI 21.27\u201334.44) and for patients with kyphotic alignment (p &lt; 0.00001, 95% CI 16.49\u201327.17). Data analysis also showed that the ACF group was associated with a higher incidence of complications (p = 0.02, 95% CI 1.08\u20132.59) and reoperations (p = 0.002, 95% CI 1.83\u201314.79), longer operation time (p = 0.01, 95% CI 17.72 \u2013160.75), and more blood loss (p = 0.0004, 95% CI 42.22\u2013148.45).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>For patients with an occupying ratio \u2265 60% or with kyphotic cervical alignment, ACF appears to be the preferable treatment method. Nevertheless, laminoplasty seems to be effective and safe enough for patients with an occupying ratio &lt; 60% or with adequate cervical lordosis. However, it must be emphasized that a surgical strategy should be made based on the individual patient. Further randomized controlled trials comparing the use of ACF with laminoplasty for the treatment of OPLL should be performed to make a more convincing conclusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.3.focus15596","type":"journal-article","created":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T03:53:12Z","timestamp":1464753192000},"page":"E8","source":"Crossref","is-referenced-by-count":45,"title":["Comparison of anterior corpectomy and fusion versus laminoplasty for the treatment of cervical ossification of posterior longitudinal ligament: a meta-analysis"],"prefix":"10.3171","volume":"40","author":[{"given":"Zihao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwen","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiqiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peigen","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Rong","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15596","series-title":"J Am Acad Orthop Surg","first-page":"420","article-title":"Surgical treatment for ossification of the posterior longitudinal ligament in the cervical spine","volume":"22","author":"An","year":"2014"},{"key":"b2-focus15596","series-title":"J Spinal Disord Tech","first-page":"24","article-title":"Surgical strategy for multilevel severe ossification of posterior longitudinal ligament in the cervical spine","volume":"24","author":"Chen","year":"2011"},{"key":"b3-focus15596","series-title":"Orthopedics","first-page":"e1231","article-title":"Surgical strategy for ossification of the posterior longitudinal ligament in the cervical spine","volume":"35","author":"Chen","year":"2012"},{"key":"b4-focus15596","series-title":"PLoS One","first-page":"e102008","article-title":"Surgical results and prognostic factors of anterior cervical corpectomy and fusion for ossification of the posterior longitudinal ligament","volume":"9","author":"Chen","year":"2014"},{"key":"b5-focus15596","series-title":"Spine J","first-page":"436","article-title":"Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament","volume":"2","author":"Epstein","year":"2002"},{"issue":"Suppl 3","key":"b6-focus15596","series-title":"Surg Neurol Int","first-page":"S88","article-title":"Cervical surgery for ossification of the posterior longitudinal ligament: One spine surgeon's perspective","volume":"5","author":"Epstein","year":"2014"},{"key":"b7-focus15596","series-title":"J Neurosurg Spine","first-page":"298","article-title":"Anterior approaches to fusion of the cervical spine: a metaanalysis of fusion rates","volume":"6","author":"Fraser","year":"2007"},{"key":"b8-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"2247","article-title":"Long-term follow-up evaluation of surgery for ossification of the posterior longitudinal ligament","volume":"20","author":"Goto","year":"1995"},{"issue":"6 Suppl","key":"b9-focus15596","series-title":"Spine J","first-page":"289S","article-title":"Laminoplasty: a review of its role in compressive cervical myelopathy","volume":"6","author":"Hale","year":"2006"},{"key":"b10-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"1969","article-title":"Neck and shoulder pain after laminoplasty. A noticeable complication","volume":"21","author":"Hosono","year":"1996"},{"key":"b11-focus15596","series-title":"BMC Med Res Methodol","first-page":"13","article-title":"Estimating the mean and variance from the median, range, and the size of a sample","volume":"5","author":"Hozo","year":"2005"},{"key":"b12-focus15596","series-title":"J Neurosurg Spine","first-page":"610","article-title":"Cervical malalignment after laminoplasty: relationship to deep extensor musculature of the cervical spine and neurological outcome","volume":"7","author":"Iizuka","year":"2007"},{"key":"b13-focus15596","series-title":"J Bone Joint Surg Br","first-page":"393","article-title":"C5 palsy after cervical laminoplasty: a multicentre study","volume":"92","author":"Imagama","year":"2010"},{"issue":"2 Suppl","key":"b14-focus15596","series-title":"J Neurosurg","first-page":"180","article-title":"Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up","volume":"96","author":"Iwasaki","year":"2002"},{"key":"b15-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"647","article-title":"Surgical strategy for cervical myelopathy due to ossification of the posterior longitudinal ligament: Part 1: Clinical results and limitations of laminoplasty","volume":"32","author":"Iwasaki","year":"2007"},{"key":"b16-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"654","article-title":"Surgical strategy for cervical myelopathy due to ossification of the posterior longitudinal ligament: Part 2: Advantages of anterior decompression and fusion over laminoplasty","volume":"32","author":"Iwasaki","year":"2007"},{"key":"b17-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"491","article-title":"Cerebrospinal fluid leak during cervical corpectomy for ossified posterior longitudinal ligament: incidence, management, and outcome","volume":"34","author":"Joseph","year":"2009"},{"key":"b18-focus15596","series-title":"Spine J","first-page":"875","article-title":"Surgical outcome and prognostic factors of anterior decompression and fusion for cervical compressive myelopathy due to ossification of the posterior longitudinal ligament","volume":"15","author":"Kim","year":"2015"},{"key":"b19-focus15596","series-title":"Photomed Laser Surg","first-page":"119","article-title":"Laser-assisted anterior cervical corpectomy versus posterior laminoplasty for cervical myelopathic patients with multilevel ossification of the posterior longitudinal ligament","volume":"26","author":"Lee","year":"2008"},{"key":"b20-focus15596","series-title":"Spine J","first-page":"1049","article-title":"A systematic review of complications in cervical spine surgery for ossification of the posterior longitudinal ligament","volume":"11","author":"Li","year":"2011"},{"key":"b21-focus15596","series-title":"Eur Spine J","first-page":"1480","article-title":"Cervical curvature, spinal cord MRIT2 signal, and occupying ratio impact surgical approach selection in patients with ossification of the posterior longitudinal ligament","volume":"22","author":"Liu","year":"2013"},{"key":"b22-focus15596","series-title":"J Spinal Disord Tech","first-page":"7","article-title":"An analysis of factors causing poor surgical outcome in patients with cervical myelopathy due to ossification of the posterior longitudinal ligament: anterior decompression with spinal fusion versus laminoplasty","volume":"20","author":"Masaki","year":"2007"},{"key":"b23-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"E309","article-title":"Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history","volume":"37","author":"Matsunaga","year":"2012"},{"issue":"3","key":"b24-focus15596","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Management of cerebrospinal fluid leaks after anterior decompression for ossification of the posterior longitudinal ligament: a review of the literature","volume":"30","author":"Mazur","year":"2011"},{"key":"b25-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"1123","article-title":"Palsy of the C5 nerve root after midsagittal-splitting laminoplasty of the cervical spine","volume":"28","author":"Minoda","year":"2003"},{"key":"b26-focus15596","series-title":"J Neurosurg Spine","first-page":"168","article-title":"Long-term results of expansive open-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine","volume":"1","author":"Ogawa","year":"2004"},{"key":"b27-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"367","article-title":"Five-year follow-up evaluation of surgical treatment for cervical myelopathy caused by ossification of the posterior longitudinal ligament: a prospective comparative study of anterior decompression and fusion with floating method versus laminoplasty","volume":"37","author":"Sakai","year":"2012"},{"key":"b28-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"2491","article-title":"Relative safety of anterior microsurgical decompression versus laminoplasty for cervical myelopathy with a massive ossified posterior longitudinal ligament","volume":"27","author":"Tani","year":"2002"},{"key":"b29-focus15596","series-title":"Ottawa Hospital Research Institute","article-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","author":"Wells"},{"key":"b30-focus15596","series-title":"J Neurosurg Spine","first-page":"59","article-title":"Long-term surgical outcome and risk factors in patients with cervical myelopathy and a change in signal intensity of intramedullary spinal cord on magnetic resonance imaging","volume":"12","author":"Yagi","year":"2010"},{"key":"b31-focus15596","series-title":"Eur Spine J","first-page":"1631","article-title":"Implications of different patterns of \u201cdouble-layer sign\u201d in cervical ossification of the posterior longitudinal ligament","volume":"24","author":"Yang","year":"2015"},{"key":"b1-focus15596","series-title":"J Am Acad Orthop Surg","first-page":"420","article-title":"Surgical treatment for ossification of the posterior longitudinal ligament in the cervical spine","volume":"22","author":"An","year":"2014"},{"key":"b2-focus15596","series-title":"J Spinal Disord Tech","first-page":"24","article-title":"Surgical strategy for multilevel severe ossification of posterior longitudinal ligament in the cervical spine","volume":"24","author":"Chen","year":"2011"},{"key":"b3-focus15596","series-title":"Orthopedics","first-page":"e1231","article-title":"Surgical strategy for ossification of the posterior longitudinal ligament in the cervical spine","volume":"35","author":"Chen","year":"2012"},{"key":"b4-focus15596","series-title":"PLoS One","first-page":"e102008","article-title":"Surgical results and prognostic factors of anterior cervical corpectomy and fusion for ossification of the posterior longitudinal ligament","volume":"9","author":"Chen","year":"2014"},{"key":"b5-focus15596","series-title":"Spine J","first-page":"436","article-title":"Diagnosis and surgical management of cervical ossification of the posterior longitudinal ligament","volume":"2","author":"Epstein","year":"2002"},{"issue":"Suppl 3","key":"b6-focus15596","series-title":"Surg Neurol Int","first-page":"S88","article-title":"Cervical surgery for ossification of the posterior longitudinal ligament: One spine surgeon's perspective","volume":"5","author":"Epstein","year":"2014"},{"key":"b7-focus15596","series-title":"J Neurosurg Spine","first-page":"298","article-title":"Anterior approaches to fusion of the cervical spine: a metaanalysis of fusion rates","volume":"6","author":"Fraser","year":"2007"},{"key":"b8-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"2247","article-title":"Long-term follow-up evaluation of surgery for ossification of the posterior longitudinal ligament","volume":"20","author":"Goto","year":"1995"},{"issue":"6 Suppl","key":"b9-focus15596","series-title":"Spine J","first-page":"289S","article-title":"Laminoplasty: a review of its role in compressive cervical myelopathy","volume":"6","author":"Hale","year":"2006"},{"key":"b10-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"1969","article-title":"Neck and shoulder pain after laminoplasty. A noticeable complication","volume":"21","author":"Hosono","year":"1996"},{"key":"b11-focus15596","series-title":"BMC Med Res Methodol","first-page":"13","article-title":"Estimating the mean and variance from the median, range, and the size of a sample","volume":"5","author":"Hozo","year":"2005"},{"key":"b12-focus15596","series-title":"J Neurosurg Spine","first-page":"610","article-title":"Cervical malalignment after laminoplasty: relationship to deep extensor musculature of the cervical spine and neurological outcome","volume":"7","author":"Iizuka","year":"2007"},{"key":"b13-focus15596","series-title":"J Bone Joint Surg Br","first-page":"393","article-title":"C5 palsy after cervical laminoplasty: a multicentre study","volume":"92","author":"Imagama","year":"2010"},{"issue":"2 Suppl","key":"b14-focus15596","series-title":"J Neurosurg","first-page":"180","article-title":"Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up","volume":"96","author":"Iwasaki","year":"2002"},{"key":"b15-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"647","article-title":"Surgical strategy for cervical myelopathy due to ossification of the posterior longitudinal ligament: Part 1: Clinical results and limitations of laminoplasty","volume":"32","author":"Iwasaki","year":"2007"},{"key":"b16-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"654","article-title":"Surgical strategy for cervical myelopathy due to ossification of the posterior longitudinal ligament: Part 2: Advantages of anterior decompression and fusion over laminoplasty","volume":"32","author":"Iwasaki","year":"2007"},{"key":"b17-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"491","article-title":"Cerebrospinal fluid leak during cervical corpectomy for ossified posterior longitudinal ligament: incidence, management, and outcome","volume":"34","author":"Joseph","year":"2009"},{"key":"b18-focus15596","series-title":"Spine J","first-page":"875","article-title":"Surgical outcome and prognostic factors of anterior decompression and fusion for cervical compressive myelopathy due to ossification of the posterior longitudinal ligament","volume":"15","author":"Kim","year":"2015"},{"key":"b19-focus15596","series-title":"Photomed Laser Surg","first-page":"119","article-title":"Laser-assisted anterior cervical corpectomy versus posterior laminoplasty for cervical myelopathic patients with multilevel ossification of the posterior longitudinal ligament","volume":"26","author":"Lee","year":"2008"},{"key":"b20-focus15596","series-title":"Spine J","first-page":"1049","article-title":"A systematic review of complications in cervical spine surgery for ossification of the posterior longitudinal ligament","volume":"11","author":"Li","year":"2011"},{"key":"b21-focus15596","series-title":"Eur Spine J","first-page":"1480","article-title":"Cervical curvature, spinal cord MRIT2 signal, and occupying ratio impact surgical approach selection in patients with ossification of the posterior longitudinal ligament","volume":"22","author":"Liu","year":"2013"},{"key":"b22-focus15596","series-title":"J Spinal Disord Tech","first-page":"7","article-title":"An analysis of factors causing poor surgical outcome in patients with cervical myelopathy due to ossification of the posterior longitudinal ligament: anterior decompression with spinal fusion versus laminoplasty","volume":"20","author":"Masaki","year":"2007"},{"key":"b23-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"E309","article-title":"Ossification of the posterior longitudinal ligament of the cervical spine: etiology and natural history","volume":"37","author":"Matsunaga","year":"2012"},{"issue":"3","key":"b24-focus15596","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Management of cerebrospinal fluid leaks after anterior decompression for ossification of the posterior longitudinal ligament: a review of the literature","volume":"30","author":"Mazur","year":"2011"},{"key":"b25-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"1123","article-title":"Palsy of the C5 nerve root after midsagittal-splitting laminoplasty of the cervical spine","volume":"28","author":"Minoda","year":"2003"},{"key":"b26-focus15596","series-title":"J Neurosurg Spine","first-page":"168","article-title":"Long-term results of expansive open-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine","volume":"1","author":"Ogawa","year":"2004"},{"key":"b27-focus15596","series-title":"Spine (Phila Pa 1976)","first-page":"367","article-title":"Five-year follow-up evaluation of surgical treatment for cervical myelopathy caused by ossification of the posterior longitudinal ligament: a prospective comparative study of anterior decompression and fusion with 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