The prognostic criteria using our scoring system were useful for the pretreatment evaluation of prognosis irrespective of the treatment modality. In any treatment, the survival period of the patients affected the functional prognosis; therefore, it may be appropriate and realistic to select treatment methods by giving first priority to the life expectancy of patients.

We reported a patient with OPLL who had undergone resurgery twice because of myelopathy due to the progression of ossification. It was important to establish a sufficiently longitudinal and transverse decompression, taking the risk of the unexpected progression of ossification into consideration.