Clinical characteristics and surgical options of cervical ossification of the posterior longitudinal ligament with trauma: a retrospective comparative study.

BACKGROUND

Trauma may aggravate the clinical outcome of cervical ossification of the posterior longitudinal ligament (OPLL), but few studies have addressed the optimal surgical strategy for cervical OPLL with trauma. This study aimed to explore the clinical characteristics and discuss surgical options for cervical OPLL with trauma.

MATERIALS AND

METHODS

Enrolled in this study were 262 patients with cervical OPLL who were treated in Shanghai Changzheng hospital between March 2008 and July 2018. Based on the presence or absence of trauma, the patients were categorized into two groups: OPLL with a trauma history (OPLL-TH group, n = 69) and OPLL with a natural progression course (OPLL-NP group, n = 193). All patients were followed up for at least 2 years postoperatively. Imaging findings, complications, and the neurological functional status were recorded and analyzed.

RESULTS

The preoperative and final follow-up Japanese Orthopedic Association (JOA) scores in the OPLL-TH group were lower than those in the OPLL-NP group. In the OPLL-TH group, the anterior surgical approach achieved higher postoperative JOA scores than the posterior surgical approach. Both preoperative and final follow-up cervical lordosis angles in the OPLL-TH group were greater than those in the OPLL-NP group. The incidences of spinal cord increased signal intensity, axial neck pain, and pneumonia in the OPLL-TH group were all higher than those in the OPLL-NP group.

CONCLUSION

The overall clinical outcome in the OPLL-TH group was poorer than that in the OPLL-NP group. The anterior surgery approach seems to provide a better clinical outcome in patients with cervical OPLL-TH as compared with the posterior approach.