title: Predictors of Surgical Outcome in Acute Spinal Cord Injury Patients with Cervical Ossification of the Posterior Longitudinal Ligament.
abstract: OBJECTIVE
  A retrospective study was conducted to clarify the predictors of the operation results for ossification of the posterior longitudinal ligament (OPLL) patients with acute spinal cord injury (SCI). Detailed analyses of surgical outcomes of OPLL patients with SCI have been rare because most surveys have aimed to investigate OPLL or SCI, but not both.
  
  
  METHODS
  A total of 36 patients who underwent operation for OPLL between January 2011 and December 2011 were included in this analysis. We investigated the patients' characteristics and surgical approaches and compared the radiographic characteristics of OPLL patients with SCI.
  
  
  RESULTS
  The mean modified Japanese Orthopaedic Association (mJOA) score improved dramatically after operation (P = 0.006). The mean preoperative mJOA score was greater in patients with Nurick 3 than in patients with Nurick 4 and 5 (P = 0.041). The preoperative mJOA score was dramatically lower in patients caused by traffic accident and in patients with segmental OPLL lesion (P < 0.05). The postoperative mJOA score was dramatically lower in patients with continuous OPLL lesion than in the segmental OPLL lesion (P = 0.028). Changing in mJOA score was significantly different between the patients with high-intensity zone (HIZ) and without HIZ on magnetic resonance imaging.
  
  
  CONCLUSIONS
  HIZ on magnetic resonance imaging was significantly related to the surgical outcomes, which should be highlighted in the preoperative communication with patients. Patients with lower Nirick grade and segmental OPLL would show better symptom before the operation. In addition, SCI caused by slipping or falling showed better symptoms before the operation. Patients with segmental OPLL should show better resolution of symptoms after the operation.
authors.affiliation: 1st Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Jiaao
authors.initials: J
authors.lastname: Gu
authors.affiliation: 1st Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Fulin
authors.initials: F
authors.lastname: Guan
authors.affiliation: Department of Epidemiology of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhu
authors.affiliation: 1st Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Guofa
authors.initials: G
authors.lastname: Guan
authors.affiliation: 1st Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Chi
authors.affiliation: 1st Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: 1st Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. Electronic address: haerbinmed@aliyun.com.
authors.forename: Zhange
authors.initials: Z
authors.lastname: Yu
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Acute spinal cord injury; Ossification of the posterior longitudinal ligament; Predictors