Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
J Spinal Cord Med. 2022 Jan;45(1):100-105. doi: 10.1080/10790268.2020.1758385. Epub 2020 May 13.
To determine the incidence of venous thromboembolism (VTE) in patients with acute cervical spinal cord injury (SCI) and ossification of the posterior longitudinal ligament (OPLL). Prospective cohort study. A department of a university hospital in Japan. This study included 57 patients (OPLL, n = 10; non-OPLL, n = 47) treated for acute cervical SCI between January 2011 and April 2017. Patients were classified according to motor complete paralysis (MC), motor incomplete paralysis (MIC), or normal motor function, based on American Spinal Injury Association (ASIA) Impairment Scale results. N/A. All patients were screened for VTE by D-dimer monitoring, and some underwent ultrasonography. If ultrasonography indicated deep venous thrombosis (DVT) or if the D-dimers increased to ≥10 µg/mL, patients underwent contrast venography to detect VTE, including DVT or pulmonary embolism. We compared blood coagulability and VTE incidence in the OPLL and non-OPLL groups. VTE occurred in 11 (19.3%) of 57 patients. The incidence of VTE was higher in the OPLL group than in the non-OPLL group (50% vs. 12.8%; P = 0.017) and higher in the MC group (57.1%) than in the MIC (8.3%; P = 0.002) or normal group (5.3%; P = 0.002). In the MC group, VTE occurred in 50% of OPLL patients and in 62.5% of non-OPLL patients (P = 0.529). In the MIC group, VTE occurred in 50% of OPLL patients and in none of the non-OPLL patients (P = 0.022). Patients with OPLL tended to develop VTE after SCI with motor complete and incomplete paralysis.
确定急性颈脊髓损伤（SCI）伴后纵韧带骨化（OPLL）患者静脉血栓栓塞症（VTE）的发生率。这是一项前瞻性队列研究，研究地点在日本一所大学附属医院的一个科室。本研究纳入了 2011 年 1 月至 2017 年 4 月期间接受急性颈 SCI 治疗的 57 例患者（OPLL 患者 10 例，非 OPLL 患者 47 例）。根据美国脊髓损伤协会（ASIA）损伤量表结果，将患者分为完全性运动瘫痪（MC）、不完全性运动瘫痪（MIC）和运动功能正常三组。所有患者均通过 D-二聚体监测进行 VTE 筛查，部分患者还接受了超声检查。如果超声提示深静脉血栓（DVT）或 D-二聚体升高至≥10µg/mL，患者则接受对比静脉造影以检测 VTE，包括 DVT 或肺栓塞。我们比较了 OPLL 和非 OPLL 两组的血液凝固性和 VTE 发生率。57 例患者中有 11 例（19.3%）发生了 VTE。OPLL 组 VTE 发生率高于非 OPLL 组（50% vs. 12.8%；P=0.017），也高于 MC 组（57.1% vs. MIC 组 8.3%；P=0.002 和正常组 5.3%；P=0.002）。在 MC 组中，OPLL 患者中有 50%发生 VTE，而非 OPLL 患者中有 62.5%发生 VTE（P=0.529）。在 MIC 组中，OPLL 患者中有 50%发生 VTE，而非 OPLL 患者中无一例发生 VTE（P=0.022）。患有 OPLL 的患者在 SCI 后发生完全性和不完全性运动瘫痪时，更易发生 VTE。
