Ossification of the posterior longitudinal ligament in the cervical spine: an 11-year comprehensive national epidemiology study

Wu, Jau Ching; Liu, Laura; Chen, Yi Chun; Huang, Wen Cheng; Chen, Tzeng Ji; Cheng, Henrich

doi:10.3171/2010.12.focus10268

Cited by 48 publications

(44 citation statements)

References 18 publications

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“…13 Furthermore, previous reports have also noted higher incidences of cervical OPLL-a known cause of CSM-among elderly and male patients. 21 These results imply a degenerative nature of CSM and cervical OPLL.…”

Section: Discussionmentioning

confidence: 78%

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Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study

Yen

et al. 2013

FOC

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176

115

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Object This study aimed to determine the age- and sex-specific incidence of cervical spondylotic myelopathy (CSM) and its associated risk of causing subsequent spinal cord injury (SCI). Methods Using the National Health Insurance Research Database (NHIRD), a 12-year nationwide database in Taiwan, this retrospective cohort study analyzed the incidence of hospitalization caused by CSM. All patients diagnosed with and admitted for CSM were identified during the study period. The CSM patients were divided into 2 groups, a control group and an operated group. An incidence density method was used to estimate age- and sex-specific incidence rates of CSM. The Kaplan-Meier method and Cox regression analyses were performed to compare the risk of SCI between the 2 groups. Results From 1998 to 2009, covering 349.5 million person-years, 14,140 patients were hospitalized for CSM. The overall incidence of CSM-related hospitalization was 4.04 per 100,000 person-years. Specifically, males and older persons had a higher incidence rate of CSM. During the follow-up of these patients for 13,461 person-years, a total of 166 patients were diagnosed with SCI. The incidence of SCI was higher in the control group than the operated group (13.9 vs 9.4 per 1000 person-years, respectively). During the follow-up, SCI was more likely to occur in CSM patients who were treated conservatively (crude HR 1.48, p = 0.023; adjusted HR 1.57, p = 0.011) than in those who underwent surgery for CSM. Conclusions In a national cohort of eastern Asia, the incidence of CSM-caused hospitalization was 4.04 per 100,000 person-years, with higher incidences observed in older and male patients. Subsequent SCI was more likely to develop in patients who received nonoperative management than in those who underwent surgery. Therefore, patients with CSM managed without surgery should be cautioned about SCI. However, further investigations are still required to clarify the risks and complications associated with surgery for CSM.

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Section: Discussionmentioning

confidence: 78%

“…5,21 Cervical OPLL is one of the eti ologies of CSM, and these 2 pathologies should therefore share many similar features. However, clinical trials have not supported the assumption that patients with spinal stenosis are prone to SCI.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study

Yen

et al. 2013

FOC

Self Cite

176

115

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“…CT scans were also performed at follow-up examinations six months and one year after the operation. Pre-and postoperative cervical lordosis on lateral radiographs was compared using the Ishihara index 13 (Fig. 3).…”

Section: Discussionmentioning

confidence: 99%

“…Patients wore a soft collar for two weeks, and were encouraged to exercise as tolerated immediately after the operation. 13 Minimal loss of cervical lordosis between pre-and postoperatively was observed on sagittal X-ray examination.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Plate-only open-door laminoplasty with fusion for treatment of multilevel degenerative cervical disease

Jiang

Zhao

et al. 2012

Journal of Clinical Neuroscience

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“…Reports have demonstrated higher incidences of OPLL in Eastern Asian countries including, Japan and Taiwan. 39,43 The patients with OPLL were excluded from the current study by preoperative CT scans even if the OPLL was of the segmental type. Patients with malignancy, infection, metabolic bone disease, severe systemic disease, or traumatic ligamentous injury were also excluded.…”

Section: Management Protocolmentioning

confidence: 99%

Postoperative nonsteroidal antiinflammatory drugs and the prevention of heterotopic ossification after cervical arthroplasty: analysis using CT and a minimum 2-year follow-up

Huang

et al. 2015

SPI

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OBJECT Heterotopic ossification (HO) after cervical arthroplasty is not uncommon and may cause immobility of the disc. To prevent HO formation, study protocols of clinical trials for cervical arthroplasty undertaken by the US FDA included perioperative use of nonsteroidal antiinflammatory drugs (NSAIDs). However, there are few data supporting the use of NSAIDs to prevent HO after cervical arthroplasty. Therefore, this study aimed to evaluate the efficacy of NSAIDs in HO formation and clinical outcomes. METHODS Consecutive patients who underwent 1- or 2-level cervical arthroplasty with a minimum follow-up of 24 months were retrospectively reviewed. All patients were grouped into 1 of 2 groups, an NSAID group (those patients who had used NSAIDs postoperatively) and a non-NSAID group (those patients who had not used NSAIDs postoperatively). The formation of HO was detected and classified using CT in every patient. The incidence of HO formation, disc mobility, and clinical outcomes, including visual analog scale (VAS) scores of neck and arm pain, neck disability index (NDI) scores, and complications were compared between the two groups. Furthermore, a subgroup analysis of the patients in the NSAID group, comparing the selective cyclooxygenase (COX)-2 to nonselective COX-2 NSAID users, was also conducted for each of the above-mentioned parameters. RESULTS A total of 75 patients (mean age [± SD] 46.71 ± 9.94 years) with 107 operated levels were analyzed. The mean follow-up duration was 38.71 ± 9.55 months. There were no significant differences in age, sex, and levels of arthroplasty between the NSAID and non-NSAID groups. There was a nonsignificantly lower rate of HO formation in the NSAID group than the non-NSAID group (47.2% vs. 68.2%, respectively; p = 0.129). During follow-up, most of the arthroplasty levels remained mobile, with similar rates of immobile discs in the NSAID and non-NSAID groups (13.2% and 22.7%, respectively; p = 0.318). Furthermore, there was a nonsignificantly lower rate of HO formation in the selective COX-2 group than the nonselective COX-2 group (30.8% vs 52.5%, respectively; p = 0.213). The clinical outcomes, including VAS neck, VAS arm, and NDI scores at 24 months postoperatively, were all similar in the NSAID and non-NSAID groups, as well as the selective and nonselective COX-2 groups (all p > 0.05). CONCLUSIONS In this study there was a trend toward less HO formation and fewer immobile discs in patients who used postoperative NSAIDs after cervical arthroplasty than those who did not, but this trend did not reach statistical significance. Patients who used selective COX-2 NSAIDs had nonsignificantly less HO than those who used nonselective COX-2 NSAIDs. The clinical outcomes were not affected by the use of NSAIDs or the kinds of NSAIDs used (selective vs nonselective COX-2). However, the study was limited by the number of patients included, and the efficacy of NSAIDs in the prevention of HO after cervical arthroplasty may need further investigation to confirm these results.

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Ossification of the posterior longitudinal ligament in the cervical spine: an 11-year comprehensive national epidemiology study

Cited by 48 publications

References 18 publications

Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study

Epidemiology of cervical spondylotic myelopathy and its risk of causing spinal cord injury: a national cohort study

Plate-only open-door laminoplasty with fusion for treatment of multilevel degenerative cervical disease

Postoperative nonsteroidal antiinflammatory drugs and the prevention of heterotopic ossification after cervical arthroplasty: analysis using CT and a minimum 2-year follow-up

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