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Does Intramedullary Signal Intensity on MRI Affect the Surgical Outcomes of Patients with Ossification of Posterior Longitudinal Ligament?

  • Choi, Jae Hyuk (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Shin, Jun Jae (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Tae Hong (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Shin, Hyung Shik (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Hwang, Yong Soon (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Park, Sang Keun (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine)
  • 투고 : 2014.06.21
  • 심사 : 2014.08.16
  • 발행 : 2014.08.28

초록

Objectives : Patients with cervical ossification of posterior longitudinal ligament (OPLL) are susceptible to cord injury, which often develops into myelopathic symptoms. However, little is known regarding the prognostic factors that are involved in minor trauma. We evaluated the relationship between minor trauma and neurological outcome of OPLL and investigated the prognostic factors with a focus on compressive factors and intramedullary signal intensity (SI). Methods : A total of 74 patients with cervical myelopathy caused by OPLL at more than three-levels were treated with posterior decompression surgeries. We surveyed the space available for spinal cord (SAC), the severity of SI change on T2-weighted image, and diabetes mellitus (DM). The neurological outcome using Japanese Orthopedic Association (JOA) scale was assessed at admission and at 12-month follow-up. Results : Among the variables tested, preoperative JOA score, severity of intramedullary SI, SAC, and DM were significantly related to neurological outcome. The mean preoperative JOA were $11.3{\pm}1.9$ for the 41 patients who did not have histories of trauma and $8.0{\pm}3.1$ for the 33 patients who had suffered minor traumas (p<0.05). However, there were no significant differences in the recovery ratios between those two groups. Conclusions : Initial neurological status and high intramedullary SI in the preoperative phase were related to poorer postoperative outcomes. Moreover, the patients with no histories of DM and larger SACs exhibited better improvement than did the patients with DM and smaller SACs. Although the initial JOA scores were worse for the minor trauma patients than did those who had no trauma prior to surgery, minor trauma exerted no direct effects on the surgical outcomes.

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참고문헌

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피인용 문헌

  1. Prognostic factors for surgical outcome in spinal cord injury associated with ossification of the posterior longitudinal ligament (OPLL) vol.10, pp.None, 2014, https://doi.org/10.1186/s13018-015-0235-3
  2. Prediction of Outcome Following Surgical Treatment of Cervical Myelopathy Based on Features of Ossification of the Posterior Longitudinal Ligament : A Systematic Review vol.5, pp.2, 2017, https://doi.org/10.2106/jbjs.rvw.16.00023
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  6. Does three-grade classification of T2-weighted increased signal intensity reflect the severity of myelopathy and surgical outcomes in patients with cervical compressive myelopathy? A systematic review vol.43, pp.3, 2020, https://doi.org/10.1007/s10143-019-01106-3
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