Factors affecting prognosis of patients who underwent corpectomy and fusion for treatment of cervical ossification of the posterior longitudinal ligament - Analysis of 47 patients

Objective: Even though cervical ossification of the posterior longitudinal ligament (OPLL) has several unique clinical features compared with spondylotic myelopathy or cervical disc disease, there have been few reports about factors affecting prognosis after decompression using corpectomy. To clarify the prognostic factors for cervical OPLL, the authors analyzed the clinical and radiologic parameters of 47 patients retrospectively. Methods: The patients were classified into a good-prognosis group and a poor-prognosis group according to the changes of Nurick grade after operation. Age at operation, gender, preoperative Nurick grade, duration of symptoms, snake-eye appearance, occupying ratio, type of OPLL, Pavlov ratio, and double-layer sign did not affect the prognosis significantly. Results: Multiple logistic regression analysis revealed that diabetes mellitus (DM) was the only statistically significant factor predicting poor prognosis for the patients with cervical OPLL who underwent corpectomy and fusion. Conclusions: Surgeons do not have to be discouraged from performing anterior decompression for the patients with cervical OPLL on the basis of age, severity of disease (preoperative Nurick grade or occupying ratio), irreversible changes in gray matter of the spinal cord (snake-eye appearance), or duration of symptoms. We should direct our attention to DM as a potent risk factor for cervical OPLL and try to clarify the mechanism by which DM possibly affected the functional recovery of the patients.