Kimura A, et al. - Researchers performed a post hoc analysis of prospective data to determine the effect of K-line (–) in the neck-flexion position [f-K-line (–)] on patient-reported outcome measures after cervical laminoplasty for patients with ossification of the posterior longitudinal ligament (OPLL). Data from 68 patients with cervical myelopathy due to OPLL who underwent double-door laminoplasty between 2008 and 2015 were prospectively collected. The categorization of patients into f-K-line (–) and f-K-line (+) groups on a baseline neck-flexion radiograph was done. The analysis revealed a significantly lower recovery rate of the Japanese Orthopaedic Association score and a significantly lower gain in EuroQol 5-Dimensional Questionnaire score in the f-K-line (–) group vs the f-K-line (+) group at the 2-year follow-up. Among the 5 domains of the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, the f-K-line (–) group exhibited significantly lower cervical function, and upper extremity function than the f-K-line (+) group. In addition, a significantly higher pain intensity in the upper and lower extremities and a significantly lower degree of satisfaction were reported among patients in the f-K-line (–) group vs those in the f-K-line (+) group. Findings thereby support a significant association of the f-K-line (–) with poorer functional recovery, higher pain intensity in the extremities, and lower patient satisfaction after cervical laminoplasty for patients with OPLL.