Predictors for the Development of Symptomatic Myelopathy in Patients with Radiculopathy Caused by Cervical Ossification of the Posterior Longitudinal Ligament.

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Predictors for the Development of Symptomatic Myelopathy in Patients with Radiculopathy Caused by Cervical Ossification of the Posterior Longitudinal Ligament.

World Neurosurg. 2019 Jan 17;:

Authors: Du YQ, Duan WR, Chen Z, Wu H, Jian FZ

Abstract
OBJECTIVE: To identify clinical factors predicting the development of myelopathy in cervical ossification of the posterior longitudinal ligament (OPLL) patients with radiculopathy.
METHODS: We retrospectively reviewed 83 cervical OPLL patients who presented with radiculopathy. Based on the symptoms and physical findings, we divided patients into 2 groups: myelopathy group and non-myelopathy group. Demographic, clinical, and radiologic characteristics were reviewed and analyzed among the 2 groups. Predictors for the development of myelopathy were assessed via univariate and multivariate analysis.
RESULTS: Univariate analysis demonstrated that high occupying ratio and presence of intramedullary high signal were risk factors of the development of myelopathy from radiculopathy in OPLL patients. Multivariate analysis further identified that high occupying ratio was the only independent predictor (OR 1.05, 95%CI 1.003-1.091, P=0.035). The cervical range of motion and minor trauma were not related to the development of myelopathy in our study.
CONCLUSIONS: Non-myelopathic OPLL patients with radiculopathy and high occupying ratio were at higher risk of developing myelopathy, and surgical intervention should be recommended in these cases. However, for elderly patients with significant comorbid conditions, the risk as well as the benefits of surgery should be carefully considered.

PMID: 30660887 [PubMed - as supplied by publisher]

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