Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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A New Classification for Cervical Ossification of the Posterior Longitudinal Ligament Based on the Coexistence of Segmental Disc Degeneration

  • Lee, Jun Ki (Department of Neurosurgery, Korea University Guro Hospital) ;
  • Ham, Chang Hwa (Department of Neurosurgery, Korea University Guro Hospital) ;
  • Kwon, Woo-Keun (Department of Neurosurgery, Korea University Guro Hospital) ;
  • Moon, Hong Joo (Department of Neurosurgery, Korea University Guro Hospital) ;
  • Kim, Joo Han (Department of Neurosurgery, Korea University Guro Hospital) ;
  • Park, Youn-Kwan (Department of Neurosurgery, Korea University Guro Hospital)
  • Received : 2020.03.16
  • Accepted : 2020.04.09
  • Published : 2021.01.01
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Abstract

Objective : Classification systems for cervical ossification of the posterior longitudinal ligament (OPLL) have traditionally focused on the morphological characteristics of ossification. Although the classification describes many clinical features associated with the shape of the ossification, including the concept of spondylosis seems necessary because of the similarity in age distribution. Methods : Patients diagnosed with OPLL who presented with increase signal intensity (ISI) on magnetic resonance imaging were surgically treated in our department. The patients were divided into two groups (pure versus degenerative) according to the presence of disc degeneration. Results : Of 141 patients enrolled in this study, more than half (61%) were classified into the degenerative group. The pure group showed a profound male predominance, early presentation of myelopathy, and a different predilection for ISI compared to the degenerative group. The mean canal compromise ratio (CC) of the ISI was 47% in the degenerative group versus 61% in the pure group (p<0.0000). On the contrary, the global and segment motions were significantly larger in the degenerative group (p<0.0000 and p=0.003, respectively). The canal diameters and global angles did not differ between groups. Conclusion : Classifying cervical OPLL based on the presence of combined disc degeneration is beneficial for understanding the disorder's behavior. CC appears to be the main factor in the development of myelopathy in the pure group, whereas additional dynamic factors appear to affect its development in the degenerative group.

Keywords

Acknowledgement

This article was presented in ASIA Spine 2019, Seoul, Korea. We would like to thank Editage (www.editage.co.kr) for English language editing.

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