{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:08:55Z","timestamp":1772827735961,"version":"3.50.1"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The impact of C5 palsy on quality of life (QOL) and its relationship with recovery and overall well-being remain poorly understood. In this study, the authors aimed to examine the effects of postoperative C5 palsy on upper extremity function and QOL in patients undergoing cervical ossification of the posterior longitudinal ligament (C-OPLL) surgery, using both objective clinical assessments and patient-reported outcome measures (PROMs). Additionally, this study aimed to explore the correlation between residual C5 palsy and QOL over a 2-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective study, using a prospective multicenter database, included 478 patients with myelopathy caused by C-OPLL, treated between 2014 and 2018, with a 2-year follow-up. Thirty-one patients developed postoperative C5 palsy (C5 palsy group), and their outcomes were compared to those of 389 patients without C5 palsy (non\u2013C5 palsy group) using propensity score matching. Within the C5 palsy group, patients were further classified based on their recovery status at 1 year postoperatively. Neurological status was assessed using the Japanese Orthopaedic Association (JOA) score, while PROMs were evaluated using the JOA Cervical Myelopathy Evaluation Questionnaire, which assesses cervical and upper extremity function, bladder function, and overall QOL. Assessments were conducted at 6 months, 1 year, and 2 years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>C5 palsy occurred in 7.4% of patients, with 61.3% achieving full recovery within 1 year. Patients in the C5 palsy group had significantly poorer upper extremity function and shoulder motor scores than those in the non\u2013C5 palsy group at all postoperative time points. However, no significant differences were observed between the groups in QOL, cervical function, lower extremity function, or bladder function. In contrast, patients with residual C5 palsy had worse QOL as well as upper extremity function compared to patients with recovered C5 palsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>While postoperative C5 palsy continues to affect motor and upper extremity function beyond 1 year, QOL scores were not significantly lower in the C5 palsy group. However, the impact on QOL in patients with residual C5 palsy may continue to slightly improve over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.6.spine25368","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:52:58Z","timestamp":1763412778000},"page":"253-261","source":"Crossref","is-referenced-by-count":0,"title":["Impact of postoperative C5 palsy on quality of life in patients with cervical ossification of the posterior longitudinal ligament: a prospective study"],"prefix":"10.3171","volume":"44","author":[{"given":"Naoki","family":"Segi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Nagoya University School of Medicine, Nagoya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nagoya University School of Medicine, Nagoya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiro","family":"Imagama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nagoya University School of Medicine, Nagoya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Egawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Science Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kudanzaka Hospital, Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunji","family":"Tsutsui","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Science Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Matsukura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Science Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanichiro","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Hirosaki;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Katsumi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Niigata University Medicine and Dental Hospital, Niigata;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masao","family":"Koda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Jichi Medical University, Shimotsuke;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeo","family":"Furuya","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narihito","family":"Nagoshi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norihiro","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Yamaguchi University School of Medicine, Ube;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukitaka","family":"Nagamoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka Rosai Hospital, Sakai;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadayuki","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nagoya University School of Medicine, Nagoya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanji","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideaki","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuma","family":"Murata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Miyagi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kaito","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Suita;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kurume University School of Medicine, Kurume;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Banno","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Ohba","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Yamanashi, Kofu;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Takahata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Moridaira","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bungo","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Katoh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruo","family":"Kanno","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Taneichi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Dokkyo Medical University School of Medicine, Tochigi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiharu","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsushi","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Jichi Medical University, Shimotsuke;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaya","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshitaka","family":"Yoshii","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Science Tokyo;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Neurosurg Spine","first-page":"316","article-title":"Risk factors for progression of ossification of the posterior longitudinal ligament in asymptomatic subjects","volume":"33","author":"Doi T","year":"2020","unstructured":"Doi T, Sakamoto R, Horii C,  Risk factors for progression of ossification of the posterior longitudinal ligament in asymptomatic subjects. J Neurosurg Spine. 2020;33(3):316\u2013322."},{"issue":"2","key":"b2","series-title":"Neurospine","first-page":"299","article-title":"Genetic odyssey to ossification of the posterior longitudinal ligament in the cervical spine: a systematic review","volume":"19","author":"Won YI","year":"2022","unstructured":"Won YI, Lee CH, Yuh WT, Kwon SW, Kim CH, Chung CK. Genetic odyssey to ossification of the posterior longitudinal ligament in the cervical spine: a systematic review. Neurospine. 2022;19(2):299\u2013306."},{"issue":"6","key":"b3","series-title":"Clin Spine Surg","first-page":"E271","article-title":"Predictors of the need for surgery in cervical ossification of the posterior longitudinal ligament: a retrospective cohort longitudinal study using a claims-based database","volume":"36","author":"Masuda S","year":"2023","unstructured":"Masuda S, Fukasawa T, Takeuchi M,  Predictors of the need for surgery in cervical ossification of the posterior longitudinal ligament: a retrospective cohort longitudinal study using a claims-based database. Clin Spine Surg. 2023;36(6):E271\u2013E276."},{"issue":"1","key":"b4","series-title":"J Orthop Surg Res","first-page":"707","article-title":"Surgical options for ossification of the posterior longitudinal ligament of the cervical spine: a narrative review","volume":"19","author":"Sun N","year":"2024","unstructured":"Sun N, Jiang C, Liu Y. Surgical options for ossification of the posterior longitudinal ligament of the cervical spine: a narrative review. J Orthop Surg Res. 2024;19(1):707."},{"issue":"4","key":"b5","series-title":"J Neurosurg Spine","first-page":"563","article-title":"Optimal timing of referral for nerve transfer surgery for postoperative C5 palsy","volume":"37","author":"Saadeh YS","year":"2022","unstructured":"Saadeh YS, Chopra Z, Olsen E,  Optimal timing of referral for nerve transfer surgery for postoperative C5 palsy. J Neurosurg Spine. 2022;37(4):563\u2013568."},{"issue":"11","key":"b6","series-title":"Ann Transl Med","first-page":"634","article-title":"Risk factors for C5 palsy following the posterior spinal process-splitting laminoplasty for cervical ossification of the posterior longitudinal ligament: a case control study","volume":"10","author":"Li N","year":"2022","unstructured":"Li N, Zhao K, An Y, Yan K, Liu B, He D. Risk factors for C5 palsy following the posterior spinal process-splitting laminoplasty for cervical ossification of the posterior longitudinal ligament: a case control study. Ann Transl Med. 2022;10(11):634\u2013634."},{"issue":"1","key":"b7","series-title":"BMC Musculoskelet Disord","first-page":"614","article-title":"Analysis of risk factors for C5 nerve root paralysis after posterior cervical decompression","volume":"22","author":"Liu B","year":"2021","unstructured":"Liu B, Chu Y, Ma J,  Analysis of risk factors for C5 nerve root paralysis after posterior cervical decompression. BMC Musculoskelet Disord. 2021;22(1):614."},{"issue":"2","key":"b8","series-title":"J Neurosurg Spine","first-page":"216","article-title":"Risk factors for C5 palsy: a systematic review and multivariate analysis","volume":"40","author":"Traynelis VC","year":"2023","unstructured":"Traynelis VC, Fontes RBV, Kasliwal MK,  Risk factors for C5 palsy: a systematic review and multivariate analysis. J Neurosurg Spine. 2023;40(2):216\u2013228."},{"issue":"4","key":"b9","series-title":"J Neurosurg Spine","first-page":"457","article-title":"Defining postoperative C5 palsy and recovery: a systematic review","volume":"38","author":"Deshpande N","year":"2022","unstructured":"Deshpande N, Stino AM, Smith BW,  Defining postoperative C5 palsy and recovery: a systematic review. J Neurosurg Spine. 2022;38(4):457\u2013464."},{"issue":"5","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"423","article-title":"Insufficient recovery from C5 palsy following anterior cervical decompression and fusion","volume":"47","author":"Odate S","year":"2022","unstructured":"Odate S, Shikata J, Yamamura S, Okahata A, Kawaguchi S, Tanaka C. Insufficient recovery from C5 palsy following anterior cervical decompression and fusion. Spine (Phila Pa 1976). 2022;47(5):423\u2013429."},{"key":"b11","series-title":"J Clin Neurosci","first-page":"112","article-title":"Manual muscle test at C5 palsy onset predicts the likelihood of and time to C5 palsy resolution","volume":"24","author":"Macki M","year":"2016","unstructured":"Macki M, Alam R, Kerezoudis P, Gokaslan Z, Bydon A, Bydon M. Manual muscle test at C5 palsy onset predicts the likelihood of and time to C5 palsy resolution. J Clin Neurosci. 2016;24:112\u2013116."},{"issue":"20","key":"b12","series-title":"J Am Acad Orthop Surg","first-page":"e890","article-title":"State-of-the-art applications of patient-reported outcome measures in spinal care","volume":"31","author":"Lee Y","year":"2023","unstructured":"Lee Y, Issa TZ, Vaccaro AR. State-of-the-art applications of patient-reported outcome measures in spinal care. J Am Acad Orthop Surg. 2023;31(20):e890\u2013e897."},{"issue":"7","key":"b13","series-title":"Cureus","first-page":"e64553","article-title":"Neurosurgical patient\u2019s quality of life: a questionnaire-based study","volume":"16","author":"Iliopoulou S","year":"2024","unstructured":"Iliopoulou S, Tzika M, Foroglou N, Iliopoulou S, Tzika M, Foroglou N. Neurosurgical patient\u2019s quality of life: a questionnaire-based study. Cureus. 2024;16(7):e64553."},{"issue":"7","key":"b14","series-title":"J Chin Med Assoc","first-page":"378","article-title":"Quantitative measures of functional outcomes and quality of life in patients with C5 palsy","volume":"76","author":"Chang PY","year":"2013","unstructured":"Chang PY, Chan RC, Tsai YA,  Quantitative measures of functional outcomes and quality of life in patients with C5 palsy. J Chin Med Assoc. 2013;76(7):378\u2013384."},{"issue":"12","key":"b15","series-title":"Spine J","first-page":"2854","article-title":"C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications","volume":"14","author":"Miller JA","year":"2014","unstructured":"Miller JA, Lubelski D, Alvin MD, Benzel EC, Mroz TE. C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications. Spine J. 2014;14(12):2854\u20132860."},{"issue":"3","key":"b16","series-title":"J Orthop Sci","first-page":"348","article-title":"JOA Back Pain Evaluation Questionnaire (JOABPEQ)\/JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) The report on the development of revised versions April 16, 2007: The Subcommittee of the Clinical Outcome Committee of the Japanese Orthopaedic Association on Low Back Pain and Cervical Myelopathy Evaluation","volume":"14","author":"Fukui M","year":"2009","unstructured":"Fukui M, Chiba K, Kawakami M,  JOA Back Pain Evaluation Questionnaire (JOABPEQ)\/JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) The report on the development of revised versions April 16, 2007: The Subcommittee of the Clinical Outcome Committee of the Japanese Orthopaedic Association on Low Back Pain and Cervical Myelopathy Evaluation. J Orthop Sci. 2009;14(3):348\u2013365."},{"key":"b17","article-title":"Japanese Orthopaedic Association Outcome Assessment Tool","unstructured":"Japanese Orthopaedic Association Outcome Assessment Tool. Accessed July 28, 2025. https:\/\/www.joa.or.jp\/english\/oat.html"},{"issue":"2","key":"b18","series-title":"J Neurosurg Spine","first-page":"103","article-title":"Multivariate analysis of C-5 palsy incidence after cervical posterior fusion with instrumentation: clinical article","volume":"17","author":"Nakashima H","year":"2012","unstructured":"Nakashima H, Imagama S, Yukawa Y,  Multivariate analysis of C-5 palsy incidence after cervical posterior fusion with instrumentation: clinical article. J Neurosurg Spine. 2012;17(2):103\u2013110."},{"issue":"26","key":"b19","first-page":"E990","article-title":"A new concept for making decisions regarding the surgical approach for cervical ossification of the posterior longitudinal ligament: the K-line. Spine (Phila Pa 1976)","volume":"33","author":"Fujiyoshi T","year":"2008","unstructured":"Fujiyoshi T, Yamazaki M, Kawabe J,  A new concept for making decisions regarding the surgical approach for cervical ossification of the posterior longitudinal ligament: the K-line. Spine (Phila Pa 1976). 2008;33(26):E990\u2013E993."},{"issue":"43","key":"b20","series-title":"J Open Source Softw","first-page":"1686","article-title":"Welcome to the Tidyverse","volume":"4","author":"Wickham H","year":"2019","unstructured":"Wickham H, Averick M, Bryan J,  Welcome to the Tidyverse. J Open Source Softw. 2019;4(43):1686."},{"issue":"1","key":"b21","series-title":"R J","first-page":"570","article-title":"Reproducible summary tables with the gtsummary package","volume":"13","author":"Sjoberg DD","year":"2021","unstructured":"Sjoberg DD, Whiting K, Curry M, Lavery JA, Larmarange J. Reproducible summary tables with the gtsummary package. R J. 2021;13(1):570\u2013580."},{"issue":"3","key":"b22","series-title":"Polit Anal","first-page":"199","article-title":"Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference","volume":"15","author":"Ho DE","year":"2007","unstructured":"Ho DE, Imai K, King G, Stuart EA. Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Polit Anal. 2007;15(3):199\u2013236."},{"key":"b23","series-title":"Annu Rev Public Health","first-page":"355","article-title":"Health-related quality of life measurement in public health","volume":"43","author":"Kaplan RM","year":"2022","unstructured":"Kaplan RM, Hays RD. Health-related quality of life measurement in public health. Annu Rev Public Health. 2022;43:355\u2013373."},{"issue":"13","key":"b24","series-title":"Ann Transl Med","first-page":"1060","article-title":"Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire as an outcome measure for ossification of posterior longitudinal ligament patients in East Asia: an investigation of reliability, validity, and responsiveness","volume":"9","author":"Li S","year":"2021","unstructured":"Li S, Kodama J, Wei L,  Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire as an outcome measure for ossification of posterior longitudinal ligament patients in East Asia: an investigation of reliability, validity, and responsiveness. Ann Transl Med. 2021;9(13):1060\u20131060."},{"issue":"15","key":"b25","first-page":"1077","article-title":"Clinical indicators of surgical outcomes after laminoplasty for patients with cervical ossification of the posterior longitudinal ligament: a prospective multicenter study. Spine (Phila Pa 1976)","volume":"47","author":"Nagoshi N","year":"2022","unstructured":"Nagoshi N, Yoshii T, Egawa S,  Clinical indicators of surgical outcomes after laminoplasty for patients with cervical ossification of the posterior longitudinal ligament: a prospective multicenter study. Spine (Phila Pa 1976). 2022;47(15):1077\u20131083."},{"issue":"8","key":"b26","series-title":"Medicina (Kaunas)","first-page":"1496","article-title":"Feasibility and efficacy of the newly developed robotic hybrid assistive limb shoulder exercises in patients with C5 palsy during the acute postoperative phase","volume":"59","author":"Kubota S","year":"2023","unstructured":"Kubota S, Kadone H, Shimizu Y,  Feasibility and efficacy of the newly developed robotic hybrid assistive limb shoulder exercises in patients with C5 palsy during the acute postoperative phase. Medicina (Kaunas). 2023;59(8):1496."},{"issue":"1","key":"b27","series-title":"Spine Surg Relat Res","first-page":"12","article-title":"Postoperative C5 palsy: conjectured causes and effective countermeasures","volume":"3","author":"Hirabayashi S","year":"2019","unstructured":"Hirabayashi S, Kitagawa T, Yamamoto I, Yamada K, Kawano H. Postoperative C5 palsy: conjectured causes and effective countermeasures. Spine Surg Relat Res. 2019;3(1):12\u201316."},{"issue":"4","key":"b28","series-title":"J Neurosurg Spine","first-page":"592","article-title":"Risk factors and preventive measures for C5 palsy after cervical open-door laminoplasty","volume":"32","author":"Nakajima H","year":"2020","unstructured":"Nakajima H, Kuroda H, Watanabe S, Honjoh K, Matsumine A. Risk factors and preventive measures for C5 palsy after cervical open-door laminoplasty. J Neurosurg Spine. 2020;32(4):592\u2013599."},{"issue":"3","key":"b1","series-title":"J Neurosurg Spine","first-page":"316","article-title":"Risk factors for progression of ossification of the posterior longitudinal ligament in asymptomatic subjects","volume":"33","author":"Doi T","year":"2020","unstructured":"Doi T, Sakamoto R, Horii C,  Risk factors for progression of ossification of the posterior longitudinal ligament in asymptomatic subjects. J Neurosurg Spine. 2020;33(3):316\u2013322."},{"issue":"2","key":"b2","series-title":"Neurospine","first-page":"299","article-title":"Genetic odyssey to ossification of the posterior longitudinal ligament in the cervical spine: a systematic review","volume":"19","author":"Won YI","year":"2022","unstructured":"Won YI, Lee CH, Yuh WT, Kwon SW, Kim CH, Chung CK. Genetic odyssey to ossification of the posterior longitudinal ligament in the cervical spine: a systematic review. Neurospine. 2022;19(2):299\u2013306."},{"issue":"6","key":"b3","series-title":"Clin Spine Surg","first-page":"E271","article-title":"Predictors of the need for surgery in cervical ossification of the posterior longitudinal ligament: a retrospective cohort longitudinal study using a claims-based database","volume":"36","author":"Masuda S","year":"2023","unstructured":"Masuda S, Fukasawa T, Takeuchi M,  Predictors of the need for surgery in cervical ossification of the posterior longitudinal ligament: a retrospective cohort longitudinal study using a claims-based database. Clin Spine Surg. 2023;36(6):E271\u2013E276."},{"issue":"1","key":"b4","series-title":"J Orthop Surg Res","first-page":"707","article-title":"Surgical options for ossification of the posterior longitudinal ligament of the cervical spine: a narrative review","volume":"19","author":"Sun N","year":"2024","unstructured":"Sun N, Jiang C, Liu Y. Surgical options for ossification of the posterior longitudinal ligament of the cervical spine: a narrative review. J Orthop Surg Res. 2024;19(1):707."},{"issue":"4","key":"b5","series-title":"J Neurosurg Spine","first-page":"563","article-title":"Optimal timing of referral for nerve transfer surgery for postoperative C5 palsy","volume":"37","author":"Saadeh YS","year":"2022","unstructured":"Saadeh YS, Chopra Z, Olsen E,  Optimal timing of referral for nerve transfer surgery for postoperative C5 palsy. J Neurosurg Spine. 2022;37(4):563\u2013568."},{"issue":"11","key":"b6","series-title":"Ann Transl Med","first-page":"634","article-title":"Risk factors for C5 palsy following the posterior spinal process-splitting laminoplasty for cervical ossification of the posterior longitudinal ligament: a case control study","volume":"10","author":"Li N","year":"2022","unstructured":"Li N, Zhao K, An Y, Yan K, Liu B, He D. Risk factors for C5 palsy following the posterior spinal process-splitting laminoplasty for cervical ossification of the posterior longitudinal ligament: a case control study. Ann Transl Med. 2022;10(11):634\u2013634."},{"issue":"1","key":"b7","series-title":"BMC Musculoskelet Disord","first-page":"614","article-title":"Analysis of risk factors for C5 nerve root paralysis after posterior cervical decompression","volume":"22","author":"Liu B","year":"2021","unstructured":"Liu B, Chu Y, Ma J,  Analysis of risk factors for C5 nerve root paralysis after posterior cervical decompression. BMC Musculoskelet Disord. 2021;22(1):614."},{"issue":"2","key":"b8","series-title":"J Neurosurg Spine","first-page":"216","article-title":"Risk factors for C5 palsy: a systematic review and multivariate analysis","volume":"40","author":"Traynelis VC","year":"2023","unstructured":"Traynelis VC, Fontes RBV, Kasliwal MK,  Risk factors for C5 palsy: a systematic review and multivariate analysis. J Neurosurg Spine. 2023;40(2):216\u2013228."},{"issue":"4","key":"b9","series-title":"J Neurosurg Spine","first-page":"457","article-title":"Defining postoperative C5 palsy and recovery: a systematic review","volume":"38","author":"Deshpande N","year":"2022","unstructured":"Deshpande N, Stino AM, Smith BW,  Defining postoperative C5 palsy and recovery: a systematic review. J Neurosurg Spine. 2022;38(4):457\u2013464."},{"issue":"5","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"423","article-title":"Insufficient recovery from C5 palsy following anterior cervical decompression and fusion","volume":"47","author":"Odate S","year":"2022","unstructured":"Odate S, Shikata J, Yamamura S, Okahata A, Kawaguchi S, Tanaka C. Insufficient recovery from C5 palsy following anterior cervical decompression and fusion. Spine (Phila Pa 1976). 2022;47(5):423\u2013429."},{"key":"b11","series-title":"J Clin Neurosci","first-page":"112","article-title":"Manual muscle test at C5 palsy onset predicts the likelihood of and time to C5 palsy resolution","volume":"24","author":"Macki M","year":"2016","unstructured":"Macki M, Alam R, Kerezoudis P, Gokaslan Z, Bydon A, Bydon M. Manual muscle test at C5 palsy onset predicts the likelihood of and time to C5 palsy resolution. J Clin Neurosci. 2016;24:112\u2013116."},{"issue":"20","key":"b12","series-title":"J Am Acad Orthop Surg","first-page":"e890","article-title":"State-of-the-art applications of patient-reported outcome measures in spinal care","volume":"31","author":"Lee Y","year":"2023","unstructured":"Lee Y, Issa TZ, Vaccaro AR. State-of-the-art applications of patient-reported outcome measures in spinal care. J Am Acad Orthop Surg. 2023;31(20):e890\u2013e897."},{"issue":"7","key":"b13","series-title":"Cureus","first-page":"e64553","article-title":"Neurosurgical patient\u2019s quality of life: a questionnaire-based study","volume":"16","author":"Iliopoulou S","year":"2024","unstructured":"Iliopoulou S, Tzika M, Foroglou N, Iliopoulou S, Tzika M, Foroglou N. Neurosurgical patient\u2019s quality of life: a questionnaire-based study. Cureus. 2024;16(7):e64553."},{"issue":"7","key":"b14","series-title":"J Chin Med Assoc","first-page":"378","article-title":"Quantitative measures of functional outcomes and quality of life in patients with C5 palsy","volume":"76","author":"Chang PY","year":"2013","unstructured":"Chang PY, Chan RC, Tsai YA,  Quantitative measures of functional outcomes and quality of life in patients with C5 palsy. J Chin Med Assoc. 2013;76(7):378\u2013384."},{"issue":"12","key":"b15","series-title":"Spine J","first-page":"2854","article-title":"C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications","volume":"14","author":"Miller JA","year":"2014","unstructured":"Miller JA, Lubelski D, Alvin MD, Benzel EC, Mroz TE. C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications. Spine J. 2014;14(12):2854\u20132860."},{"issue":"3","key":"b16","series-title":"J Orthop Sci","first-page":"348","article-title":"JOA Back Pain Evaluation Questionnaire (JOABPEQ)\/JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) The report on the development of revised versions April 16, 2007: The Subcommittee of the Clinical Outcome Committee of the Japanese Orthopaedic Association on Low Back Pain and Cervical Myelopathy Evaluation","volume":"14","author":"Fukui M","year":"2009","unstructured":"Fukui M, Chiba K, Kawakami M,  JOA Back Pain Evaluation Questionnaire (JOABPEQ)\/JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) The report on the development of revised versions April 16, 2007: The Subcommittee of the Clinical Outcome Committee of the Japanese Orthopaedic Association on Low Back Pain and Cervical Myelopathy Evaluation. J Orthop Sci. 2009;14(3):348\u2013365."},{"key":"b17","article-title":"Japanese Orthopaedic Association Outcome Assessment Tool","unstructured":"Japanese Orthopaedic Association Outcome Assessment Tool. Accessed July 28, 2025. https:\/\/www.joa.or.jp\/english\/oat.html"},{"issue":"2","key":"b18","series-title":"J Neurosurg Spine","first-page":"103","article-title":"Multivariate analysis of C-5 palsy incidence after cervical posterior fusion with instrumentation: clinical article","volume":"17","author":"Nakashima H","year":"2012","unstructured":"Nakashima H, Imagama S, Yukawa Y,  Multivariate analysis of C-5 palsy incidence after cervical posterior fusion with instrumentation: clinical article. J Neurosurg Spine. 2012;17(2):103\u2013110."},{"issue":"26","key":"b19","first-page":"E990","article-title":"A new concept for making decisions regarding the surgical approach for cervical ossification of the posterior longitudinal ligament: the K-line. Spine (Phila Pa 1976)","volume":"33","author":"Fujiyoshi T","year":"2008","unstructured":"Fujiyoshi T, Yamazaki M, Kawabe J,  A new concept for making decisions regarding the surgical approach for cervical ossification of the posterior longitudinal ligament: the K-line. Spine (Phila Pa 1976). 2008;33(26):E990\u2013E993."},{"issue":"43","key":"b20","series-title":"J Open Source Softw","first-page":"1686","article-title":"Welcome to the Tidyverse","volume":"4","author":"Wickham H","year":"2019","unstructured":"Wickham H, Averick M, Bryan J,  Welcome to the Tidyverse. J Open Source Softw. 2019;4(43):1686."},{"issue":"1","key":"b21","series-title":"R J","first-page":"570","article-title":"Reproducible summary tables with the gtsummary package","volume":"13","author":"Sjoberg DD","year":"2021","unstructured":"Sjoberg DD, Whiting K, Curry M, Lavery JA, Larmarange J. Reproducible summary tables with the gtsummary package. R J. 2021;13(1):570\u2013580."},{"issue":"3","key":"b22","series-title":"Polit Anal","first-page":"199","article-title":"Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference","volume":"15","author":"Ho DE","year":"2007","unstructured":"Ho DE, Imai K, King G, Stuart EA. Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Polit Anal. 2007;15(3):199\u2013236."},{"key":"b23","series-title":"Annu Rev Public Health","first-page":"355","article-title":"Health-related quality of life measurement in public health","volume":"43","author":"Kaplan RM","year":"2022","unstructured":"Kaplan RM, Hays RD. Health-related quality of life measurement in public health. Annu Rev Public Health. 2022;43:355\u2013373."},{"issue":"13","key":"b24","series-title":"Ann Transl Med","first-page":"1060","article-title":"Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire as an outcome measure for ossification of posterior longitudinal ligament patients in East Asia: an investigation of reliability, validity, and responsiveness","volume":"9","author":"Li S","year":"2021","unstructured":"Li S, Kodama J, Wei L,  Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire as an outcome measure for ossification of posterior longitudinal ligament patients in East Asia: an investigation of reliability, validity, and responsiveness. Ann Transl Med. 2021;9(13):1060\u20131060."},{"issue":"15","key":"b25","first-page":"1077","article-title":"Clinical indicators of surgical outcomes after laminoplasty for patients with cervical ossification of the posterior longitudinal ligament: a prospective multicenter study. Spine (Phila Pa 1976)","volume":"47","author":"Nagoshi N","year":"2022","unstructured":"Nagoshi N, Yoshii T, Egawa S,  Clinical indicators of surgical outcomes after laminoplasty for patients with cervical ossification of the posterior longitudinal ligament: a prospective multicenter study. Spine (Phila Pa 1976). 2022;47(15):1077\u20131083."},{"issue":"8","key":"b26","series-title":"Medicina (Kaunas)","first-page":"1496","article-title":"Feasibility and efficacy of the newly developed robotic hybrid assistive limb shoulder exercises in patients with C5 palsy during the acute postoperative phase","volume":"59","author":"Kubota S","year":"2023","unstructured":"Kubota S, Kadone H, Shimizu Y,  Feasibility and efficacy of the newly developed robotic hybrid assistive limb shoulder exercises in patients with C5 palsy during the acute postoperative phase. Medicina (Kaunas). 2023;59(8):1496."},{"issue":"1","key":"b27","series-title":"Spine Surg Relat Res","first-page":"12","article-title":"Postoperative C5 palsy: conjectured causes and effective countermeasures","volume":"3","author":"Hirabayashi S","year":"2019","unstructured":"Hirabayashi S, Kitagawa T, Yamamoto I, Yamada K, Kawano H. Postoperative C5 palsy: conjectured causes and effective countermeasures. Spine Surg Relat Res. 2019;3(1):12\u201316."},{"issue":"4","key":"b28","series-title":"J Neurosurg Spine","first-page":"592","article-title":"Risk factors and preventive measures for C5 palsy after cervical open-door laminoplasty","volume":"32","author":"Nakajima H","year":"2020","unstructured":"Nakajima H, Kuroda H, Watanabe S, Honjoh K, Matsumine A. Risk factors and preventive measures for C5 palsy after cervical open-door laminoplasty. J Neurosurg Spine. 2020;32(4):592\u2013599."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/2\/article-p253.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/2\/article-p253.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/2\/article-p253.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:45:46Z","timestamp":1772804746000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/2\/article-p253.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":56,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2025.6.spine25368","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,7]]}}}