Keigo Ito, Yasutsugu Yukawa, Masaaki Machino, Fumihiko Kato


November 2013, Volume 22, Issue 11, pp 2564 - 2568 Original Article Read Full Article 10.1007/s00586-013-2982-3

First Online: 28 August 2013

Purpose

The pathomechanism of cervical myelopathy due to cervical ossification of posterior longitudinal ligament (C-OPLL) remains unclear. No previous literature has quantified the influence of dynamic factors on cervical myelopathy due to C-OPLL. The purpose was to investigate the influence of dynamic factors on the spinal column in the patients with C-OPLL using CT scan after myelography (MCT).

Methods

The study included 41 patients with cervical myelopathy due to C-OPLL. An MCT was done during neck flexion and extension, and spinal cord cross-sectional areas (SCCSA) were measured at each disc level between C2/3 and C7/T1. Ossification morphology at each segment was divided into three groups, connection department, coating part, and non-connection department of OPLL group. Dynamic changes of SCCSA in each group of ossification morphology were calculated. The relationship between clinical results and SCCSA at the narrowest level was investigated.

Results

MCT showed SCCSA changes during neck extension; 7.4 ± 5.1 mm2 in the connection department, 5.8 ± 6.0 mm2 in the coating part, and 6.7 ± 6.4 mm2 in the non-connection department of OPLL group. There difference was not statistically significant. There was a weak correlation between the JOA score and SCCSA at the narrowest level (R = 0.49). There was no significant correlation between the recovery rate of JOA score and SCCSA at the narrowest level (R = 0.37).

Conclusion

Dynamic factors are seen both in cervical myelopathy patients with the continuous type of OPLL and others. Deterioration of myelopathy could be induced by motion effects even in the connection department of OPLL.


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