Chen Guanghui, Fan Tianqi, Chen Zhongqiang, Li Weishi, Qi Qiang, Guo Zhaoqing, Zhong Woquan, Jiang Yu, Song Chunli, Sun Chuiguo
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
Beijing Key Laboratory of Spinal Disease Research, Beijing, China.
Global Spine J. 2024 Nov;14(8):2288-2297. doi: 10.1177/21925682231174194. Epub 2023 May 6.
Retrospective cohort study.
To describe the clinical characteristics and surgical outcomes of patients with multilevel-ossification of the posterior longitudinal ligament (mT-OPLL), and to identify risk factors for unfavorable outcomes.
Patients who were diagnosed with mT-OPLL and underwent one-stage thoracic posterior laminectomy combined with selective OPLL resection, spinal cord de-tension, and fusion surgery between August 2012 and October 2020 were recruited. Patients' demographic-, surgical- and radiological-related parameters were collected and analyzed. Neurological status was evaluated with mJOA score, and recovery rate (RR) was calculated using the Hirabayashi formula. According to RR, patients were divided into a favorable outcome group (FOG, RR ≥50%) and an unfavorable outcome group (UOG, RR <50%). Univariate and multivariate analyses were used to compare the difference between the 2 groups and to identify risk factors for unfavorable outcomes.
A total of 83 patients were included, with an average age of 50.6 ± 8.3 years. Cerebrospinal fluid leakage (60.2%) and transient neurological deterioration (9.6%) were the most common complications. The average mJOA score improved from preoperative 4.3 ± 2.2 to 9.0 ± 2.4 at the last follow-up, and the mean RR was 74.9 ± 26.3%. Disease duration, preoperative nonambulatory status, and the number of decompressed levels were identified as potential risk factors by Univariate analysis (all P < .05). Multivariate analysis showed that the preoperative disease duration and nonambulatory status were independent risk factors for unfavorable outcomes.
Long disease duration and nonambulatory status before surgery were independent risk factors for unfavorable outcomes.
回顾性队列研究。
描述多节段后纵韧带骨化症（mT-OPLL）患者的临床特征和手术结果，并确定不良预后的危险因素。
招募2012年8月至2020年10月期间被诊断为mT-OPLL并接受一期胸段后路椎板切除术联合选择性OPLL切除术、脊髓减压和融合手术的患者。收集并分析患者的人口统计学、手术和放射学相关参数。用改良日本骨科学会（mJOA）评分评估神经功能状态，并使用平林公式计算恢复率（RR）。根据RR，将患者分为预后良好组（FOG，RR≥50%）和预后不良组（UOG，RR<50%）。采用单因素和多因素分析比较两组之间的差异，并确定不良预后的危险因素。
共纳入83例患者，平均年龄50.6±8.3岁。脑脊液漏（60.2%）和短暂性神经功能恶化（9.6%）是最常见的并发症。末次随访时，平均mJOA评分从术前的4.3±2.2提高到9.0±2.4，平均RR为74.9±26.3%。单因素分析确定病程、术前不能行走状态和减压节段数为潜在危险因素（均P<.05）。多因素分析显示，术前病程和不能行走状态是不良预后的独立危险因素。
术前病程长和不能行走状态是不良预后的独立危险因素。
