Qadri Haseeb Mehmood, Khan Manal, Ansari Nasruddin, Khizar Ahtesham, Bukhari Syed Faizan Ahmad, Bashir Asif
Haseeb Mehmood Qadri, MBBS Postgraduate Resident Neurosurgery, Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Manal Khan, MBBS Postgraduate Resident Neurosurgery, Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Pak J Med Sci. 2024 Dec;40(12PINS Suppl):S63-S68. doi: 10.12669/pjms.40.12(PINS).11094.
To analyze the efficacy of K-line in surgical planning of approach selection for ossification of posterior longitudinal ligament (OPLL) and outcomes assessment by Nurick grading and Modified Japanese Orthopaedic Association (mJOA) scores.
This is a retrospective case series study conducted at the Departments of Neurosurgery, Punjab Institute of Neurosciences, Lahore in the months of January and February 2024. Patients with complete records were considered. Google Form was used for data. Nurick grading and Modified Japanese Orthopaedic Association (mJOA) scores were calculated for each patient pre- and post-operatively. K-line assessment was done on computerized tomography (CT). Data analysis was performed using Microsoft excel in terms of frequency and percentages.
This study included ten patients with the mean age at presentation was 48.20 ± 9.37 years. Preoperative Nurick grading in our patients was Grade-V (five patients), Grade-IV (two patients) and Grade-III (three patients) with mean of 4.2 ± 0.91 SD whereas six months follow-up Nurick grading was Grade-V (three patients), Grade-IV (three patients) and Grade-III (four patients) with the mean of 3.90 ± 0.87 SD, which indicates neurological improvement. Types of OPLL present in our patients were segmental (4, 40%), continuous (3, 30%), mixed (2, 20%) and localized/others (1, 10%). There were 2 (20%) K-line (+) and 8 (80%) K-line (-) cases. Anterior approach was used in 2 (20%) cases whereas posterior approach was used for the rest of 8 (80%) cases. Mean preoperative mJOA was 10.30 ± 2.45 and mean postoperative mJOA was12.40 ± 2.01 at 6-month follow up, which indicates improvement in our cases.
K-line is a useful radiological indicator in selecting anterior versus posterior approach for patients with cervical OPLL in terms of Nurick grading and mJOA scores.
分析K线在颈椎后纵韧带骨化症（OPLL）手术入路选择规划中的有效性，并通过Nurick分级和改良日本骨科学会（mJOA）评分进行疗效评估。
这是一项回顾性病例系列研究，于2024年1月和2月在拉合尔旁遮普神经科学研究所神经外科进行。纳入有完整记录的患者。使用谷歌表单收集数据。对每位患者术前和术后计算Nurick分级和改良日本骨科学会（mJOA）评分。在计算机断层扫描（CT）上进行K线评估。使用Microsoft excel对数据进行频率和百分比分析。
本研究纳入10例患者，平均就诊年龄为48.20±9.37岁。患者术前Nurick分级为Ⅴ级（5例）、Ⅳ级（2例）和Ⅲ级（3例），平均为4.2±0.91标准差；而随访6个月时Nurick分级为Ⅴ级（3例）、Ⅳ级（3例）和Ⅲ级（4例），平均为3.90±0.87标准差，表明神经功能有所改善。患者中存在的OPLL类型为节段性（4例，40%）、连续性（3例，30%）、混合型（2例，20%）和局限性/其他型（1例，10%）。有2例（20%）K线阳性和8例（80%）K线阴性病例。2例（20%）采用前路手术，其余8例（80%）采用后路手术。随访6个月时，术前mJOA平均为10.30±2.45，术后mJOA平均为12.40±2.01，表明病例有所改善。
就Nurick分级和mJOA评分而言，K线是选择颈椎OPLL患者前路与后路手术入路的有用影像学指标。
