Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Global Spine J. 2015 Apr;5(2):124-9. doi: 10.1055/s-0034-1397340. Epub 2015 Jan 7.
Study Design Retrospective study. Objective Minor trauma, even from a simple fall, can often cause cervical myelopathy, necessitating surgery in elderly patients who may be unaware of their posterior longitudinal ligament ossification (OPLL). The aim of this study is to determine the influence of trauma on the neurologic course in patients who have undergone surgery for cervical OPLL. Methods Patients who underwent surgery due to OPLL were divided by trauma history and compared (34 in the trauma group; 70 in the nontrauma group). Results Ground falls were the most common type of trauma (20 patients, low-energy injuries), but 23 patients developed new symptoms after a trauma. Although the symptom duration (17.68 months) was shorter, the Japanese Orthopedic Association (JOA) score and the Nurick scale showed lower values in the trauma group. Trauma histories led patients to earlier hospital visits. Initial JOA scores were associated with a good recovery status upon the last follow-up in both the groups. The narrowest diameter of the spinal canal showed different radiologic parameters: 5.78 mm in the trauma group and 6.52 mm in the nontrauma group. Conclusion Minor trauma can cause the unexpected development of new symptoms in patients unaware of cervical OPLL. Patients with a history of trauma had lower initial JOA scores and showed a narrower spinal canal compared with a nontrauma group. The initial JOA scores were correlated with a good recovery status upon the last follow-up.
回顾性研究。目的：即使是轻微的创伤，甚至是简单的跌倒，也常常导致颈椎脊髓病，在可能不知道自己存在后纵韧带骨化（OPLL）的老年患者中需要手术。本研究旨在确定创伤对颈椎 OPLL 手术后患者神经病程的影响。方法：根据创伤史将接受手术治疗 OPLL 的患者进行分组并进行比较（创伤组 34 例；非创伤组 70 例）。结果：最常见的创伤类型是平地跌倒（20 例，低能量损伤），但有 23 例患者在创伤后出现新症状。尽管创伤组的症状持续时间（17.68 个月）较短，但日本骨科协会（JOA）评分和 Nurick 量表的评分值较低。创伤史导致患者更早地就诊。两组中，最初的 JOA 评分与最后一次随访时的良好恢复状态相关。椎管最窄直径显示出不同的影像学参数：创伤组为 5.78mm，非创伤组为 6.52mm。结论：轻微创伤可导致颈椎 OPLL 患者出现新的、意料之外的症状。有创伤史的患者最初的 JOA 评分较低，与无创伤组相比，椎管更窄。最初的 JOA 评分与最后一次随访时的良好恢复状态相关。
