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Clinical and Imaging Predictors of Surgical Outcome in Multilevel Cervical Ossification of Posterior Longitudinal Ligament: An Analysis of 184 Patients.

Gu Y, Shi J, Cao P, Yuan W, Wu H, Yang L, Tian Y, Liang L - PLoS ONE (2015)

Bottom Line: A JOA recovery rate less than 50% was considered a poor outcome.Patients in poor outcome group were more likely to present kyphotic cervical alignment, smaller mean transverse area of the spinal cord, and intramedullary signal abnormalities.The result of multivariate stepwise logistic regression showed that a longer duration of symptoms and the presence of T1 hypo-intensity intramedullary changes on MRI were significant risk factors of lower JOA recovery ratios.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.

ABSTRACT

Objective: To investigate the clinical and imaging predictors of surgical outcomes in patients with ossification of the posterior longitudinal ligament (OPLL).

Materials and methods: From May 2010 to April 2012, a total of 200 consecutive patients with cervical OPLL were recruited for this study. Of them, 184 patients (130 men and 54 women) who could be tracked for more than 24 months after surgery were finally included for analysis. Their demographic, clinical and radiological data were collected preoperatively. The recovery ratio in terms of JOA score was used to assess the outcome of the patients preoperatively and at 2 years postoperatively. A JOA recovery rate less than 50% was considered a poor outcome.

Results: Compared with good outcome group, an older mean age at operation, a longer mean duration of symptoms, a lower mean pre-operativer JOA score, and a higher proportion of diabetics were observed in poor outcome group. Patients in poor outcome group were more likely to present kyphotic cervical alignment, smaller mean transverse area of the spinal cord, and intramedullary signal abnormalities. The result of multivariate stepwise logistic regression showed that a longer duration of symptoms and the presence of T1 hypo-intensity intramedullary changes on MRI were significant risk factors of lower JOA recovery ratios.

Conclusion: A longer duration of symptom, T1 hypointensity on MRI and a history of minor trauma were highly predictive of a poor outcome for patients undergoing surgical treatment of OPLL. Age at operation, the history of diabetes, the preoperative JOA score, the transverse area of the spinal cord and T2 hyper-intensity on MRI were also associated with the prognosis of OPLL.

No MeSH data available.


Related in: MedlinePlus

Morphological types of OPLL were classified into the continuous type (a), segmental type (b), circumscribed type (c) and mixed type (d) according to Hirabayashi's classification.
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pone.0136042.g002: Morphological types of OPLL were classified into the continuous type (a), segmental type (b), circumscribed type (c) and mixed type (d) according to Hirabayashi's classification.

Mentions: Morphological types of OPLL were classified as the continuous type, segmental type, circumscribed type and mixed type according to the classification by Hirabayashi et al [12] (Fig 2). The shape of ossification was defined as the wide-base type and narrow-base type on CT axial imaging, and plateau-shaped and hill-shaped on sagittal imaging (Fig 3).


Clinical and Imaging Predictors of Surgical Outcome in Multilevel Cervical Ossification of Posterior Longitudinal Ligament: An Analysis of 184 Patients.

Gu Y, Shi J, Cao P, Yuan W, Wu H, Yang L, Tian Y, Liang L - PLoS ONE (2015)

Morphological types of OPLL were classified into the continuous type (a), segmental type (b), circumscribed type (c) and mixed type (d) according to Hirabayashi's classification.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556618&req=5

pone.0136042.g002: Morphological types of OPLL were classified into the continuous type (a), segmental type (b), circumscribed type (c) and mixed type (d) according to Hirabayashi's classification.
Mentions: Morphological types of OPLL were classified as the continuous type, segmental type, circumscribed type and mixed type according to the classification by Hirabayashi et al [12] (Fig 2). The shape of ossification was defined as the wide-base type and narrow-base type on CT axial imaging, and plateau-shaped and hill-shaped on sagittal imaging (Fig 3).

Bottom Line: A JOA recovery rate less than 50% was considered a poor outcome.Patients in poor outcome group were more likely to present kyphotic cervical alignment, smaller mean transverse area of the spinal cord, and intramedullary signal abnormalities.The result of multivariate stepwise logistic regression showed that a longer duration of symptoms and the presence of T1 hypo-intensity intramedullary changes on MRI were significant risk factors of lower JOA recovery ratios.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.

ABSTRACT

Objective: To investigate the clinical and imaging predictors of surgical outcomes in patients with ossification of the posterior longitudinal ligament (OPLL).

Materials and methods: From May 2010 to April 2012, a total of 200 consecutive patients with cervical OPLL were recruited for this study. Of them, 184 patients (130 men and 54 women) who could be tracked for more than 24 months after surgery were finally included for analysis. Their demographic, clinical and radiological data were collected preoperatively. The recovery ratio in terms of JOA score was used to assess the outcome of the patients preoperatively and at 2 years postoperatively. A JOA recovery rate less than 50% was considered a poor outcome.

Results: Compared with good outcome group, an older mean age at operation, a longer mean duration of symptoms, a lower mean pre-operativer JOA score, and a higher proportion of diabetics were observed in poor outcome group. Patients in poor outcome group were more likely to present kyphotic cervical alignment, smaller mean transverse area of the spinal cord, and intramedullary signal abnormalities. The result of multivariate stepwise logistic regression showed that a longer duration of symptoms and the presence of T1 hypo-intensity intramedullary changes on MRI were significant risk factors of lower JOA recovery ratios.

Conclusion: A longer duration of symptom, T1 hypointensity on MRI and a history of minor trauma were highly predictive of a poor outcome for patients undergoing surgical treatment of OPLL. Age at operation, the history of diabetes, the preoperative JOA score, the transverse area of the spinal cord and T2 hyper-intensity on MRI were also associated with the prognosis of OPLL.

No MeSH data available.


Related in: MedlinePlus