This letter to the editor discusses concerns regarding a study on the progression of ossification of the posterior longitudinal ligament (OPLL) in patients who underwent laminoplasty. The authors argue that the study failed to consider the influence of comorbidities, rehabilitation, psychosocial factors, and lifestyle variables on patient outcomes and recovery. They suggest that incorporating these elements into future research would provide a more comprehensive understanding of OPLL treatment and improve the validity and usefulness of the study. The authors of the letter contributed to the study's conception and design, and no competing interests or funding sources were reported.