Multilevel ossification of the posterior longitudinal ligament causing cervical myelopathy: An observational series of North American patients.
Publication/Presentation Date
1-1-2023
Abstract
BACKGROUND: Few studies regarding ossification of the posterior longitudinal ligament (OPLL) outside of Asia currently exist in the literature. A set of patients with multilevel cervical OPLL causing symptomatic myelopathy or radiculopathy from a North American sample is analyzed.
OBJECTIVE: The objective of this study was to describe the demographics, radiographic findings, and surgical outcomes of a cohort of North American patients with degenerative spondylosis presenting for operative management of multilevel (>3 segments) cervical OPLL.
MATERIALS AND METHODS: Forty-three patients diagnosed with multilevel cervical OPLL and degenerative spondylosis presenting with symptomatic cervical myelopathy or radiculopathy were surgically treated over a 9-year period at a single tertiary care academic medical center. Radiographic measurements were performed on preoperative computed tomography and magnetic resonance imaging images of the cervical spine. Clinical outcomes included pre- and postoperative Nurick scores, 90-day readmission, complication, and revision surgery rates.
RESULTS: The mean age was 66.1 ± 10.9 years with a mean latest follow-up time of 32.7 ± 16.4 months. Most patients had previous diagnoses of obesity (70.7%) and hypertension (55.8%). At least one-quarter of patients were diagnosed with type 2 diabetes (34.9%), hyperlipidemia (41.9%), cardiovascular disease (25.6%), or chronic kidney disease (25.3%). The most common OPLL subtype was segmental (39.5%) and spanned a mean of 3.54 ± 1.48 segments. Myelopathic symptoms were present in 88.4% of patients. All patients experienced significant neurologic improvement at 3-week and latest follow-up (
CONCLUSIONS: Obesity, diabetes, and other metabolic derangements in patients with existing cervical spondylosis may be risk factors for a particularly aggressive form of multilevel OPLL. Various operative approaches may be employed to achieve adequate neurologic recovery. Further workup for OPLL in patients with these risk factors may prove beneficial to ensure appropriate operative management.
Volume
14
Issue
3
First Page
292
Last Page
298
ISSN
0974-8237
Published In/Presented At
Ledesma, J. A., Issa, T. Z., Lambrechts, M. J., Hiranaka, C. G., Tran, K., O'Connor, P., Canseco, J. A., Hilibrand, A. S., Kepler, C. K., Albert, T. J., Vaccaro, A. R., Schroeder, G. D., & Anderson, D. G. (2023). Multilevel ossification of the posterior longitudinal ligament causing cervical myelopathy: An observational series of North American patients. Journal of craniovertebral junction & spine, 14(3), 292–298. https://doi.org/10.4103/jcvjs.jcvjs_90_23
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
37860025
Department(s)
Administration and Leadership
Document Type
Article