The radiological characteristics associated with the development of myelopathy due to ossification of the posterior longitudinal ligaments at each responsible level based on spinal cord evoked potentials.
Adult
Aged
Aged, 80 and over
Biomechanical Phenomena
Cervical Vertebrae
/ diagnostic imaging
Evoked Potentials
Female
Humans
Intraoperative Neurophysiological Monitoring
Magnetic Resonance Imaging
Male
Middle Aged
Neurosurgical Procedures
Ossification of Posterior Longitudinal Ligament
/ complications
Prospective Studies
Range of Motion, Articular
Spinal Cord
/ physiopathology
Spinal Cord Compression
/ surgery
Spinal Cord Diseases
/ diagnostic imaging
Tomography, X-Ray Computed
MRI hyperintensity
OPLL
alignment
cervical myelopathy
dynamic factor
kinematic CT myelography
range of motion
spinal cord evoked potentials
Journal
Clinical neurology and neurosurgery
ISSN: 1872-6968
Titre abrégé: Clin Neurol Neurosurg
Pays: Netherlands
ID NLM: 7502039
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
01
02
2020
revised:
09
03
2020
accepted:
20
03
2020
pubmed:
17
4
2020
medline:
12
6
2021
entrez:
17
4
2020
Statut:
ppublish
Résumé
This was a retrospective study of prospectively collected data. This study aimed to characterize the factors associated with the development of myelopathy at each cervical level based on spinal cord evoked potentials (SCEPs) and radiological parameters in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Static factors, dynamic factors, and combinations of these factors are associated with the development of OPLL-related myelopathy. Fifty patients with OPLL were enrolled in this study. They underwent kinematic computed tomography myelography (CTM), MRI, and X-ray examinations, and the levels responsible for their myelopathy were determined by intraoperatively assessing SCEPs. C2-7 lordosis, C2-7 range of motion (ROM), and segmental ROM were assessed on the midsagittal view during flexion and extension and in the neutral position using the Cobb method, and the cross-sectional area of the spinal cord (CSA) was measured on the axial view in each neck position using kinematic CTM. The cervical levels were classified into responsible (Group R) and non-responsible (Group N) levels. The responsible level was C3-4, C4-5, C5-6, and C6-7 in 18, 23, 18, and 4 patients, respectively. In the multivariate analysis, the CSA was significantly smaller in Group R than in Group N at all responsible levels, but the dynamic change in the CSA was only associated with myelopathy at the C3-4 and C4-5 levels. Myelopathy at the C3-4 level was more strongly associated with dynamic factors and a shorter disease duration, than myelopathy at the C5-6 level. This study provides useful information for assessing the pathophysiology of OPLL-related cervical myelopathy and managing the condition.
Sections du résumé
STUDY DESIGN
This was a retrospective study of prospectively collected data.
OBJECTIVE
This study aimed to characterize the factors associated with the development of myelopathy at each cervical level based on spinal cord evoked potentials (SCEPs) and radiological parameters in patients with cervical ossification of the posterior longitudinal ligament (OPLL).
SUMMARY OF BACKGROUND DATA
Static factors, dynamic factors, and combinations of these factors are associated with the development of OPLL-related myelopathy.
PATIENTS AND METHODS
Fifty patients with OPLL were enrolled in this study. They underwent kinematic computed tomography myelography (CTM), MRI, and X-ray examinations, and the levels responsible for their myelopathy were determined by intraoperatively assessing SCEPs. C2-7 lordosis, C2-7 range of motion (ROM), and segmental ROM were assessed on the midsagittal view during flexion and extension and in the neutral position using the Cobb method, and the cross-sectional area of the spinal cord (CSA) was measured on the axial view in each neck position using kinematic CTM. The cervical levels were classified into responsible (Group R) and non-responsible (Group N) levels.
RESULTS
The responsible level was C3-4, C4-5, C5-6, and C6-7 in 18, 23, 18, and 4 patients, respectively. In the multivariate analysis, the CSA was significantly smaller in Group R than in Group N at all responsible levels, but the dynamic change in the CSA was only associated with myelopathy at the C3-4 and C4-5 levels.
CONCLUSION
Myelopathy at the C3-4 level was more strongly associated with dynamic factors and a shorter disease duration, than myelopathy at the C5-6 level. This study provides useful information for assessing the pathophysiology of OPLL-related cervical myelopathy and managing the condition.
Identifiants
pubmed: 32298951
pii: S0303-8467(20)30157-8
doi: 10.1016/j.clineuro.2020.105814
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105814Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.