Factors affecting prognosis of patients who underwent corpectomy and fusion for treatment of cervical ossification of the posterior longitudinal ligament: analysis of 47 patients.
OBJECTIVE
Even though cervical ossification of the posterior longitudinal ligament (OPLL) has several unique clinical features compared with spondylotic myelopathy or cervical disc disease, there have been few reports about factors affecting prognosis after decompression using corpectomy. To clarify the prognostic factors for cervical OPLL, the authors analyzed the clinical and radiologic parameters of 47 patients retrospectively.


METHODS
The patients were classified into a good-prognosis group and a poor-prognosis group according to the changes of Nurick grade after operation. Age at operation, gender, preoperative Nurick grade, duration of symptoms, snake-eye appearance, occupying ratio, type of OPLL, Pavlov ratio, and double-layer sign did not affect the prognosis significantly.


RESULTS
Multiple logistic regression analysis revealed that diabetes mellitus (DM) was the only statistically significant factor predicting poor prognosis for the patients with cervical OPLL who underwent corpectomy and fusion.


CONCLUSIONS
Surgeons do not have to be discouraged from performing anterior decompression for the patients with cervical OPLL on the basis of age, severity of disease (preoperative Nurick grade or occupying ratio), irreversible changes in gray matter of the spinal cord (snake-eye appearance), or duration of symptoms. We should direct our attention to DM as a potent risk factor for cervical OPLL and try to clarify the mechanism by which DM possibly affected the functional recovery of the patients.
Choi
Seokmin
S
Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea.
Lee
Sang-Ho
SH
Lee
Ji-Young
JY
Choi
Won Gyu
WG
Choi
Won-Chul
WC
Choi
Gun
G
Jung
Byungjoo
B
Lee
Seung Cheol
SC
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects; D014057:Tomography, X-Ray Computed