Potential risk factors for poor outcome after anterior surgery for patients with cervical ossification of the posterior longitudinal ligament

• Published in: Therapeutics and clinical risk management Vol. 14; pp. 341 - 347
• Main Authors: Li, Shaoqing, Zhang, Peng, Gao, Xianda, Miao, Dechao, Gao, Yanlong, Shen, Yong
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Age; Bone surgery; cerebrospinal leakage; cervical ossification of the posterior longitudinal ligament; Hospitals; Human papillomavirus; K-line; Ligaments; Medical imaging; Medical research; Neurologic manifestations; Neuromuscular diseases; NMR; Nuclear magnetic resonance; occupying ratio; Original Research; Patients; Postoperative period; Regression analysis; residual ratio; Risk factors; Spinal cord; Surgical outcomes; China; residual ratio; occupying ratio; cervical ossification of the posterior longitudinal ligament; cerebrospinal leakage; K-line
• ISSN: 1176-6336; 1178-203X; 1178-203X
• DOI: 10.2147/TCRM.S152416

Our purpose here was to identify risk factors of poor outcome after anterior operation in patients with cervical ossification of the posterior longitudinal ligament (OPLL). This study retrospectively reviewed 98 patients who underwent anterior surgery for improving neurological symptoms. The Japanese Orthopedic Association (JOA) recovery rate <50% was defined as poor surgical outcome. We investigated the relationship between various predictors and outcome by logistic regression analysis and receiver operating characteristic curves. To explore the cause of cerebrospinal fluid (CSF) leakage, we used the Mann-Whitney -test, test, or independent -test. Multivariate logistic regression analysis showed that age (odds ratio [OR] =1.1, 95% confidence interval [CI] =1.03-1.18, =0.005), occupying ratio of OPLL (OR =1.08, 95% CI =1.03-1.12, =0.001), and residual ratio of OPLL (OR =1.07, 95% CI =1.02-1.13, =0.008) were independently associated with poor outcome. The cutoffs of the above risk factors were set at 63.5 years, 39.65%, and 25.165%, respectively. Predictors for CSF leakage were occupying ratio of OPLL, the K-line, and shape of the ossified lesion ( <0.001, =0.019, and =0.003). These findings suggest that advanced age, high occupying ratio of OPLL, and high residual ratio of OPLL were risk factors for postoperative poor outcome in patients with OPLL. In addition, the high occupying ratio of OPLL, the K-line (-), and hill-shape ossification were potential causes of CSF leakage.