Publications

Background: The most common cause of radiculopathy or myelopathy is “ossification of the posterior longitudinal ligament (OPLL).” Surgical management consists of various anterior and posterior procedures. Anterior procedures done are corpectomy and fusion. Posterior procedures include laminectomy and laminectomy with fusion that include the use of lateral mass or pedicle screws with rods. The objective was to study the clinical course and to delineate clinico-radiological prognostic factors with regard to surgical outcome. 

Methods: Patients operated on for cervical OPLL were included. Detailed clinical history and radiological findings were retrospectively taken from the case records of the patients and prospectively recorded in the cases operated till May 2018. A minimum follow-up of 6 months was done for improvement. Preoperative clinical evaluation was done. Surgical options were individualized for each patient. A detailed clinical evaluation was done at discharge and at follow-up. Results: It has been found that those patients who were admitted with Nurick’s myelopathy grade IV and VAT admission, those with a higher number of levels involved, like 5, 6, and 7, and those with a duration of symptoms of more than one year were more likely to have the same or a deteriorated outcome compared to their counterparts. Other parameters were not found to be significantly associated with the outcome. 

Conclusions: Duration of symptoms > 12 months and sphincter disturbances were significant poor clinical prognostic markers. Significantly poor radiological prognostic markers were a segmental stenotic index < 0.4 and an MRI T2-weighted hyperintense signal change.