Journal of Korean Neurosurgical Society

  • 제59권5호
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  • Pages.471-477
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  • 2016
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Compression Angle of Ossification of the Posterior Longitudinal Ligament and Its Clinical Significance in Cervical Myelopathy

  • Lee, Nam (Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine) ;
  • Yoon, Do Heum (Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine) ;
  • Kim, Keung Nyun (Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine) ;
  • Shin, Hyun Chul (Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shin, Dong Ah (Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine) ;
  • Ha, Yoon (Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine)
  • 투고 : 2016.01.20
  • 심사 : 2016.06.01
  • 발행 : 2016.09.01
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초록

Objectives : The correction of clinical and radiologic abnormalities in patients with symptomatic ossification of the posterior longitudinal ligament (OPLL) is the current mainstay of treatment. This study aimed to identify radiographic predictors of severity of myelopathy in patients with symptomatic OPLL. Methods : Fifty patients with symptomatic cervical OPLL were enrolled. Based on Japanese Orthopedic Association (JOA) scores, patients were divided into either the mild myelopathy (n=31) or severe myelopathy (n=19) group. All subjects underwent preoperative plain cervical roentgenogram, computed tomography (CT), and MR imaging (MRI). Radiological parameters (C2-7 sagittal vertical axis, SVA; C2-7 Cobb angle; C2-7 range of motion, ROM; OPLL occupying ratio; and compression angle) were compared. Compression angle of OPLL was defined as the angle between the cranial and caudal surfaces of OPLL at the maximum level of cord compression Results : The occupying ratio of the spinal canal, C2-7 Cobb angle, C2-7 SVA, types of OPLL, and C2-7 ROM of the cervical spine were not statistically different between the two groups. However, the OPLL compression angle was significantly greater (p=0.003) in the severe myelopathy group than in the mild myelopathy group and was inversely correlated with JOA score (r=-0.533, p<0.01). Furthermore, multivariate regression analysis demonstrated that the compression angle (B=-0.069, p<0.001) was significantly associated with JOA scores (R=0.647, p<0.005). Conclusion : Higher compression angles of OPLL have deleterious effects on the spinal cord and decrease preoperative JOA scores.

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참고문헌

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피인용 문헌

  1. Analysis of the spinal cord angle for severe cervical ossification of the posterior longitudinal ligament: comparison between anterior controllable antedisplacement and fusion (ACAF) and posterior lam vol.29, pp.5, 2016, https://doi.org/10.1007/s00586-019-06216-6